Provider Demographics
NPI:1811041874
Name:GENSBIGLER, JOSEPH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:GENSBIGLER
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 1:40 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-737-4321
Mailing Address - Fax:717-737-4357
Practice Address - Street 1:40 N 36TH ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:717-737-4321
Practice Address - Fax:717-737-4357
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015103L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000650963-0002Medicaid