Provider Demographics
NPI:1992853014
Name:LOGRIPPO, PHILIP (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:LOGRIPPO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 CASTELLO DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-8901
Mailing Address - Country:US
Mailing Address - Phone:239-261-5566
Mailing Address - Fax:239-262-8032
Practice Address - Street 1:1044 CASTELLO DR
Practice Address - Street 2:SUITE 110
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8901
Practice Address - Country:US
Practice Address - Phone:239-261-5566
Practice Address - Fax:239-262-8032
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11482122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist