Provider Demographics
NPI:1215026125
Name:JOHN C DRUHE DDS PC
Entity Type:Organization
Organization Name:JOHN C DRUHE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CECIL
Authorized Official - Last Name:DRUHE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-475-7161
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:42 GANNON'S SQUARE
Mailing Address - City:PEVELY
Mailing Address - State:MO
Mailing Address - Zip Code:63070-0268
Mailing Address - Country:US
Mailing Address - Phone:636-475-7161
Mailing Address - Fax:636-479-6127
Practice Address - Street 1:42 GANNON'S SQUARE
Practice Address - Street 2:
Practice Address - City:PEVELY
Practice Address - State:MO
Practice Address - Zip Code:63070
Practice Address - Country:US
Practice Address - Phone:636-475-7161
Practice Address - Fax:636-479-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty