Provider Demographics
NPI:1700249943
Name:STRATTON FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:STRATTON FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:270-841-7366
Mailing Address - Street 1:3355 WESTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-7986
Mailing Address - Country:US
Mailing Address - Phone:270-841-7366
Mailing Address - Fax:
Practice Address - Street 1:301 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1841
Practice Address - Country:US
Practice Address - Phone:812-386-6677
Practice Address - Fax:812-385-5473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011749A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty