Provider Demographics
NPI:1912096827
Name:DRUHE, JOHN CECIL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CECIL
Last Name:DRUHE
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 268
Mailing Address - Street 2:42 GANNON'S SQUARE
Mailing Address - City:PEVELY
Mailing Address - State:MO
Mailing Address - Zip Code:63070-0268
Mailing Address - Country:US
Mailing Address - Phone:636-475-7161
Mailing Address - Fax:636-479-6127
Practice Address - Street 1:42 GANNON'S SQUARE
Practice Address - Street 2:
Practice Address - City:PEVELY
Practice Address - State:MO
Practice Address - Zip Code:63070-0268
Practice Address - Country:US
Practice Address - Phone:636-475-7161
Practice Address - Fax:636-479-6127
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice