Healthcare Provider Details

I. General information

NPI: 1477531200
Provider Name (Legal Business Name): WILLIAM CHARLES STRUTZ JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7070 RENNER RD SUITE 201
SHAWNEE KS
66217-3047
US

IV. Provider business mailing address

7070 RENNER RD SUITE 201
SHAWNEE KS
66217-3047
US

V. Phone/Fax

Practice location:
  • Phone: 913-268-0808
  • Fax: 913-268-3080
Mailing address:
  • Phone: 913-268-0808
  • Fax: 913-268-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number5738
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: