Provider Demographics
NPI:1235202466
Name:STRAIT, TASHA TAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TASHA
Middle Name:TAWN
Last Name:STRAIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W. RAVEN ST.
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011
Mailing Address - Country:US
Mailing Address - Phone:952-873-6380
Mailing Address - Fax:952-873-6382
Practice Address - Street 1:201 W RAVEN ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011-1704
Practice Address - Country:US
Practice Address - Phone:952-873-6380
Practice Address - Fax:952-873-6382
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice