Provider Demographics
NPI:1497918759
Name:TROUT, WILLIAM HOWARD JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOWARD
Last Name:TROUT
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:HOWARD
Other - Last Name:TROUT
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31402-0401
Mailing Address - Country:US
Mailing Address - Phone:912-355-1512
Mailing Address - Fax:912-330-1018
Practice Address - Street 1:5209 PAULSEN STREET
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4804
Practice Address - Country:US
Practice Address - Phone:912-355-1512
Practice Address - Fax:912-330-1018
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10747122300000X
GA17047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist