Provider Demographics
NPI:1598372211
Name:STRIEGEL FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:STRIEGEL FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:STRIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-949-7677
Mailing Address - Street 1:302 GRANT LINE CTR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2103
Mailing Address - Country:US
Mailing Address - Phone:812-949-7677
Mailing Address - Fax:812-949-7671
Practice Address - Street 1:302 GRANT LINE CTR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2103
Practice Address - Country:US
Practice Address - Phone:812-949-7677
Practice Address - Fax:812-949-7671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental