Provider Demographics
NPI:1225045115
Name:DAMICH, LOUIS EMIL JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:EMIL
Last Name:DAMICH
Suffix:JR
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 1:212 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017
Mailing Address - Country:US
Mailing Address - Phone:412-221-1400
Mailing Address - Fax:412-221-5774
Practice Address - Street 1:212 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017
Practice Address - Country:US
Practice Address - Phone:412-221-1400
Practice Address - Fax:412-221-5774
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020020L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist