Provider Demographics
NPI:1790284719
Name:WILLIAM STRUPP JR DDS PA
Entity Type:Organization
Organization Name:WILLIAM STRUPP JR DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STRUPP
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-799-1011
Mailing Address - Street 1:2376 SUNSET POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1423
Mailing Address - Country:US
Mailing Address - Phone:727-799-1011
Mailing Address - Fax:727-797-6993
Practice Address - Street 1:2376 SUNSET POINT RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1423
Practice Address - Country:US
Practice Address - Phone:727-799-1011
Practice Address - Fax:727-797-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty