Provider Demographics
NPI:1578735049
Name:GIRLINGHOUSE, JUDGE DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDGE
Middle Name:DAVID
Last Name:GIRLINGHOUSE
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 1:1309 NE 29TH TER
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4883
Mailing Address - Country:US
Mailing Address - Phone:772-201-8190
Mailing Address - Fax:
Practice Address - Street 1:1930 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-7293
Practice Address - Country:US
Practice Address - Phone:772-201-8190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN6016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist