Provider Demographics
NPI:1386889798
Name:KNAPKE, WILLIAM C (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:KNAPKE
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 1:705 N 14TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-4205
Mailing Address - Country:US
Mailing Address - Phone:352-323-1338
Mailing Address - Fax:352-323-0896
Practice Address - Street 1:617 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3922
Practice Address - Country:US
Practice Address - Phone:850-872-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 5866122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist