Provider Demographics
NPI:1821006362
Name:GIRSCH, WILLIAM J JR (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:GIRSCH
Suffix:JR
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 1:830 LIBERTY ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2450
Mailing Address - Country:US
Mailing Address - Phone:503-585-3636
Mailing Address - Fax:503-362-0377
Practice Address - Street 1:830 LIBERTY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2450
Practice Address - Country:US
Practice Address - Phone:503-585-3636
Practice Address - Fax:503-362-0377
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD51761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics