Provider Demographics
NPI:1194784272
Name:STREIFF, WILLIAM A (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:STREIFF
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 1:550 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144
Mailing Address - Country:US
Mailing Address - Phone:704-636-7215
Mailing Address - Fax:704-636-2898
Practice Address - Street 1:550 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-636-7215
Practice Address - Fax:704-636-2898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3759204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8998151Medicaid
NC98151OtherBLUE CROSS BLUE SHIELD
T63782Medicare UPIN
NC241026Medicare ID - Type Unspecified