Provider Demographics
NPI:1780698894
Name:STROHMEYER, GARY ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ROBERT
Last Name:STROHMEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1326
Mailing Address - Country:US
Mailing Address - Phone:563-557-7400
Mailing Address - Fax:
Practice Address - Street 1:3300 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-1326
Practice Address - Country:US
Practice Address - Phone:563-557-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1500066Medicaid
IAT 01022Medicare UPIN