Provider Demographics
NPI:1366447351
Name:LINGER, JERRY N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:N
Last Name:LINGER
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 1:663 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:WV
Mailing Address - Zip Code:26034-1383
Mailing Address - Country:US
Mailing Address - Phone:304-387-3801
Mailing Address - Fax:304-387-9899
Practice Address - Street 1:663 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:WV
Practice Address - Zip Code:26034-1383
Practice Address - Country:US
Practice Address - Phone:304-387-3801
Practice Address - Fax:304-387-9899
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice