Provider Demographics
NPI:1326778952
Name:STRABALA, DAVID JOHN (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:STRABALA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:STRABALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:135 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-2811
Mailing Address - Country:US
Mailing Address - Phone:319-283-4222
Mailing Address - Fax:319-283-5686
Practice Address - Street 1:135 7TH ST SE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-2811
Practice Address - Country:US
Practice Address - Phone:319-283-4222
Practice Address - Fax:319-283-4222
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice