Provider Demographics
NPI:1851494819
Name:GEORGE W RUPPRECHT JR D.D.S.P.A.
Entity Type:Organization
Organization Name:GEORGE W RUPPRECHT JR D.D.S.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:RUPPRECHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-821-5553
Mailing Address - Street 1:208 FULFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3814
Mailing Address - Country:US
Mailing Address - Phone:410-836-7800
Mailing Address - Fax:410-879-7770
Practice Address - Street 1:208 FULFORD AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3814
Practice Address - Country:US
Practice Address - Phone:410-836-7800
Practice Address - Fax:410-879-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD43661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD326067OtherQUEST
PA272271OtherUNITED CONCORDIA
MD19811875OtherLABCORE
MD326216OtherQUEST
PA103926OtherUNITED CONCORDIA