Provider Demographics
NPI:1518304112
Name:LURZ, WILLIAM G (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:LURZ
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 1:102 E SOUTH ST
Mailing Address - Street 2:PO BOX 98
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-5508
Mailing Address - Country:US
Mailing Address - Phone:402-684-2919
Mailing Address - Fax:402-684-2919
Practice Address - Street 1:102 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-5508
Practice Address - Country:US
Practice Address - Phone:402-684-2919
Practice Address - Fax:402-684-2919
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47069403000Medicaid