Provider Demographics
NPI:1477766343
Name:STREICH, DENNIS KEITH (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:KEITH
Last Name:STREICH
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 E RAY ROAD
Mailing Address - Street 2:BLDG 5 SUITE #122
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4703
Mailing Address - Country:US
Mailing Address - Phone:480-759-2020
Mailing Address - Fax:480-759-2915
Practice Address - Street 1:4350 E RAY ROAD
Practice Address - Street 2:BLDG 5 SUITE #122
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4703
Practice Address - Country:US
Practice Address - Phone:480-759-2020
Practice Address - Fax:480-759-2915
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist