Provider Demographics
NPI:1124188644
Name:WINTER, R PHILIP (DDS)
Entity Type:Individual
Prefix:MR
First Name:R
Middle Name:PHILIP
Last Name:WINTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:PHILIP
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1420 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654
Mailing Address - Country:US
Mailing Address - Phone:559-638-2321
Mailing Address - Fax:559-638-8565
Practice Address - Street 1:1420 11TH STREET
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654
Practice Address - Country:US
Practice Address - Phone:559-638-2321
Practice Address - Fax:559-638-8565
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA368521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice