Provider Demographics
NPI:1134323009
Name:WEINTRAUB, GERALD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:S
Last Name:WEINTRAUB
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 1:333 FRIENDSHIP LN
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7259
Mailing Address - Country:US
Mailing Address - Phone:717-337-0273
Mailing Address - Fax:
Practice Address - Street 1:2285 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7214
Practice Address - Country:US
Practice Address - Phone:717-337-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017140L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics