Provider Demographics
NPI:1225282494
Name:DENTAL CORPORATION OF LOUIS STROMBERG DDS
Entity Type:Organization
Organization Name:DENTAL CORPORATION OF LOUIS STROMBERG DDS
Other - Org Name:HIGH DESERT SMILES DENTISTRY AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:Z
Authorized Official - Last Name:STROMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-947-9853
Mailing Address - Street 1:2860 MICHELLE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1009
Mailing Address - Country:US
Mailing Address - Phone:714-368-2077
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:12821 MAIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-9126
Practice Address - Country:US
Practice Address - Phone:760-947-9853
Practice Address - Fax:760-956-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty