Provider Demographics
NPI:1639290992
Name:RANKIN, GEORGE EDWARD IV (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EDWARD
Last Name:RANKIN
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:EDWARD
Other - Last Name:RANKIN
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1999 MARLTON PIKE E
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1825
Mailing Address - Country:US
Mailing Address - Phone:856-424-3186
Mailing Address - Fax:856-424-7923
Practice Address - Street 1:1999 MARLTON PIKE E
Practice Address - Street 2:SUITE 1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1825
Practice Address - Country:US
Practice Address - Phone:856-424-3186
Practice Address - Fax:856-424-7923
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1020105001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice