Provider Demographics
NPI:1376793315
Name:LOUIS S. WINNER, JR., D.D.S., P.A.
Entity Type:Organization
Organization Name:LOUIS S. WINNER, JR., D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:SANDS
Authorized Official - Last Name:WINNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-748-5303
Mailing Address - Street 1:525 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745
Mailing Address - Country:US
Mailing Address - Phone:570-748-5303
Mailing Address - Fax:570-748-5324
Practice Address - Street 1:525 HIGH STREET
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745
Practice Address - Country:US
Practice Address - Phone:570-748-5303
Practice Address - Fax:570-748-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-015553-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty