Provider Demographics
NPI:1679094627
Name:FIRCHA, LINDA MARJORIE (PHDHP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARJORIE
Last Name:FIRCHA
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 QUENTIN RD BOX 1069
Mailing Address - Street 2:
Mailing Address - City:QUENTIN
Mailing Address - State:PA
Mailing Address - Zip Code:17083
Mailing Address - Country:US
Mailing Address - Phone:717-277-8168
Mailing Address - Fax:
Practice Address - Street 1:2525 QUENTIN RD # 1069
Practice Address - Street 2:
Practice Address - City:QUENTIN
Practice Address - State:PA
Practice Address - Zip Code:17083
Practice Address - Country:US
Practice Address - Phone:717-277-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH007357L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist