Provider Demographics
NPI:1821186156
Name:WOODRUFF, STEVE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:WOODRUFF
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 1:504 RICHARDSON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-3430
Mailing Address - Country:US
Mailing Address - Phone:903-675-5411
Mailing Address - Fax:903-675-7775
Practice Address - Street 1:504 RICHARDSON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3430
Practice Address - Country:US
Practice Address - Phone:903-675-5411
Practice Address - Fax:903-675-7775
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice