Provider Demographics
NPI:1407877681
Name:STROHSCHEIN MCGARVIN DDS LLC
Entity Type:Organization
Organization Name:STROHSCHEIN MCGARVIN DDS LLC
Other - Org Name:FISHCER MCGARVIN DDS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-686-1605
Mailing Address - Street 1:109 W LAKEWAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-6352
Mailing Address - Country:US
Mailing Address - Phone:307-686-1605
Mailing Address - Fax:307-682-4659
Practice Address - Street 1:109 W LAKEWAY RD STE B
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-6352
Practice Address - Country:US
Practice Address - Phone:307-686-1605
Practice Address - Fax:307-682-4659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY112509500Medicaid