Provider Demographics
NPI:1861589533
Name:PEOPLES, KRUGER WM (DDS)
Entity type:Individual
Prefix:DR
First Name:KRUGER
Middle Name:WM
Last Name:PEOPLES
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 1:4429 GRIGGS RD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2852
Mailing Address - Country:US
Mailing Address - Phone:713-842-2500
Mailing Address - Fax:713-842-4224
Practice Address - Street 1:4429 GRIGGS RD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2852
Practice Address - Country:US
Practice Address - Phone:713-842-2500
Practice Address - Fax:713-842-4224
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
86D473OtherBCBS
TX090841003Medicaid