Provider Demographics
NPI:1891895199
Name:LINGER, EDWARD L (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:L
Last Name:LINGER
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 1:516 COST AVE
Mailing Address - Street 2:
Mailing Address - City:STONEWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4811
Mailing Address - Country:US
Mailing Address - Phone:304-624-5250
Mailing Address - Fax:304-624-5251
Practice Address - Street 1:1510 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-8500
Practice Address - Country:US
Practice Address - Phone:304-636-2009
Practice Address - Fax:304-636-0109
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV34681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001854OtherWV DENTAL MEDICAL CARD