Provider Demographics
NPI:1831334739
Name:GINGRICH, PHILIP LAWRENCE (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LAWRENCE
Last Name:GINGRICH
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 1:38 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4431
Mailing Address - Country:US
Mailing Address - Phone:717-243-9300
Mailing Address - Fax:717-258-4055
Practice Address - Street 1:38 STATE AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4431
Practice Address - Country:US
Practice Address - Phone:717-243-9300
Practice Address - Fax:717-258-4055
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026878L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice