Provider Demographics
NPI:1720138605
Name:LATULIPPE, LOUIS J (DMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:LATULIPPE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PEARL DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4268
Mailing Address - Country:US
Mailing Address - Phone:386-671-0404
Mailing Address - Fax:386-671-0405
Practice Address - Street 1:6 PEARL DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4268
Practice Address - Country:US
Practice Address - Phone:386-671-0404
Practice Address - Fax:386-671-0405
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00136911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry