Provider Demographics
NPI:1952467540
Name:STRUVE, WILLIAM ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:STRUVE
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:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56096
Mailing Address - Country:US
Mailing Address - Phone:507-362-8474
Mailing Address - Fax:507-362-8486
Practice Address - Street 1:204 N 4TH STREET
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:MN
Practice Address - Zip Code:56096
Practice Address - Country:US
Practice Address - Phone:507-362-8474
Practice Address - Fax:507-362-8486
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND78861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice