Provider Demographics
NPI:1366456774
Name:SHIPMAN, WILLIAM G (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:SHIPMAN
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 1:1931 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-291-1166
Mailing Address - Fax:717-397-0842
Practice Address - Street 1:1931 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-291-1166
Practice Address - Fax:717-397-0842
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020184L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice