Provider Demographics
NPI:1811090855
Name:RUPPRECHT, GEORGE WALTER JR (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WALTER
Last Name:RUPPRECHT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD43661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103926OtherUNITED CONCORDIA
PA272271OtherUNITED CONCORDIA