Provider Demographics
NPI:1417034885
Name:PRINTZ, WILLIAM D
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:PRINTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:D
Other - Last Name:D
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1340 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-2060
Mailing Address - Country:US
Mailing Address - Phone:308-254-7171
Mailing Address - Fax:
Practice Address - Street 1:1340 10TH AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2060
Practice Address - Country:US
Practice Address - Phone:308-254-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE47671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025804400Medicaid