Provider Demographics
NPI:1083721955
Name:STRAUSS & STRAUSS D.M.D.S, PA
Entity Type:Organization
Organization Name:STRAUSS & STRAUSS D.M.D.S, PA
Other - Org Name:ORAL FACIAL SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SORRELL
Authorized Official - Middle Name:IZEN
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-283-6757
Mailing Address - Street 1:821 SE OCEAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2456
Mailing Address - Country:US
Mailing Address - Phone:772-283-6757
Mailing Address - Fax:772-283-8701
Practice Address - Street 1:821 E OCEAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2456
Practice Address - Country:US
Practice Address - Phone:772-283-6757
Practice Address - Fax:772-283-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4064Medicare ID - Type UnspecifiedMEDICARE GROUP#