Provider Demographics
NPI:1467733915
Name:STRANGE, GEOFFREY R (DDS)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:R
Last Name:STRANGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12835 NEWCASTLE WAY UNIT 304
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1316
Mailing Address - Country:US
Mailing Address - Phone:425-644-1770
Mailing Address - Fax:425-644-1912
Practice Address - Street 1:12835 NEWCASTLE WAY UNIT 304
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1316
Practice Address - Country:US
Practice Address - Phone:425-644-1770
Practice Address - Fax:425-644-1912
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000056251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1497877476OtherTYPE 2 NPI