Provider Demographics
NPI:1437342540
Name:MARTIN STRASSNER DDS A PROF CORP
Entity Type:Organization
Organization Name:MARTIN STRASSNER DDS A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRASSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-252-7641
Mailing Address - Street 1:27211 CAMP PLENTY RD
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-2634
Mailing Address - Country:US
Mailing Address - Phone:661-252-7641
Mailing Address - Fax:
Practice Address - Street 1:27211 CAMP PLENTY RD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-2634
Practice Address - Country:US
Practice Address - Phone:661-252-7641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD22182OtherMEDICAL