Provider Demographics
NPI:1790867455
Name:BUCHHOLZ, WILLIAM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:BUCHHOLZ
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 1:5401 N UNIVERSITY DR
Mailing Address - Street 2:STE 101
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4636
Mailing Address - Country:US
Mailing Address - Phone:954-752-4484
Mailing Address - Fax:954-752-9577
Practice Address - Street 1:5401 N UNIVERSITY DR
Practice Address - Street 2:STE 101
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4636
Practice Address - Country:US
Practice Address - Phone:954-752-4484
Practice Address - Fax:954-752-9577
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN56451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice