Provider Demographics
NPI:1740302439
Name:WINNER, LOUIS SANDS JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:SANDS
Last Name:WINNER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:LOUIS
Other - Middle Name:SANDS
Other - Last Name:WINNER
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS PA
Mailing Address - Street 1:525 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745
Mailing Address - Country:US
Mailing Address - Phone:570-748-5303
Mailing Address - Fax:570-748-5324
Practice Address - Street 1:525 HIGH STREET
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745
Practice Address - Country:US
Practice Address - Phone:570-748-5303
Practice Address - Fax:570-748-5324
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0155531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice