Provider Demographics
NPI:1134381643
Name:TRUAX, WILLIAM HOWARD III (DMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HOWARD
Last Name:TRUAX
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 MCGREGOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3416
Mailing Address - Country:US
Mailing Address - Phone:239-334-6136
Mailing Address - Fax:239-334-2556
Practice Address - Street 1:2041 MCGREGOR BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3416
Practice Address - Country:US
Practice Address - Phone:239-334-6136
Practice Address - Fax:239-334-2556
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist