MEDICARE: WILLIAM HOWARD TRUAX III DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN18360	FL

General Provider Information

NPI Number	:	1134381643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HOWARD TRUAX III DMD

Provider Business Mailing Address
First Line	:	2041 MCGREGOR BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3416
Country	:	US
Telephone Number	:	239-334-6136
Fax Number	:	239-334-2556

Provider Business Practice Location Address
First Line	:	2041 MCGREGOR BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3416
Country	:	US
Telephone Number	:	239-334-6136
Fax Number	:	239-334-2556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	06/26/2008

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