Provider Demographics
NPI:1235121302
Name:SHARON C STRONG DMD PC
Entity Type:Organization
Organization Name:SHARON C STRONG DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-347-5555
Mailing Address - Street 1:155 DELAWARE AVE SE
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-9471
Mailing Address - Country:US
Mailing Address - Phone:541-347-5555
Mailing Address - Fax:541-347-5145
Practice Address - Street 1:155 DELAWARE AVE SE
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411-9471
Practice Address - Country:US
Practice Address - Phone:541-347-5555
Practice Address - Fax:541-347-5145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06797208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty