Provider Demographics
NPI:1558673160
Name:THOMAS S. STRAND DDS
Entity Type:Organization
Organization Name:THOMAS S. STRAND DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-243-4366
Mailing Address - Street 1:12611 HESPERIA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8307
Mailing Address - Country:US
Mailing Address - Phone:760-243-4366
Mailing Address - Fax:
Practice Address - Street 1:12611 HESPERIA RD
Practice Address - Street 2:SUITE C
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8307
Practice Address - Country:US
Practice Address - Phone:760-243-4366
Practice Address - Fax:760-243-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1801997481Medicaid
CA26540OtherDENTAL LICENSE