Provider Demographics
NPI:1245253756
Name:LOOZE, RICHARD JOHN (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:LOOZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22970 E SMOKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1382
Mailing Address - Country:US
Mailing Address - Phone:720-886-0606
Mailing Address - Fax:720-886-0610
Practice Address - Street 1:22970 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1382
Practice Address - Country:US
Practice Address - Phone:720-886-0606
Practice Address - Fax:720-886-0610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist