Provider Demographics
NPI:1962496497
Name:JUNGHANS, PHILIP SERAPHIN (DDS, CERT IN ORTHO)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:SERAPHIN
Last Name:JUNGHANS
Suffix:
Gender:M
Credentials:DDS, CERT IN ORTHO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 9 BOX 5516
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-0056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 9 BOX 5516
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09123-0056
Practice Address - Country:US
Practice Address - Phone:0049656-561-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics