Provider Demographics
NPI:1407395189
Name:STRATMAN KIDS DENTISTRY
Entity Type:Organization
Organization Name:STRATMAN KIDS DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-745-6871
Mailing Address - Street 1:801 N WILMOT RD STE D2
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1715
Mailing Address - Country:US
Mailing Address - Phone:520-745-6871
Mailing Address - Fax:520-790-7710
Practice Address - Street 1:801 N WILMOT RD STE D2
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1715
Practice Address - Country:US
Practice Address - Phone:520-745-6871
Practice Address - Fax:520-790-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ57111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty