Provider Demographics
NPI:1558664417
Name:STROHMAN DENTAL
Entity Type:Organization
Organization Name:STROHMAN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STROHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-224-9877
Mailing Address - Street 1:4210 KELL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-4802
Mailing Address - Country:US
Mailing Address - Phone:940-613-0299
Mailing Address - Fax:
Practice Address - Street 1:4210 KELL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-4802
Practice Address - Country:US
Practice Address - Phone:940-613-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty