Provider Demographics
NPI:1801240601
Name:STRAWBRIDGE DENTAL, P.C.
Entity type:Organization
Organization Name:STRAWBRIDGE DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLIE
Authorized Official - Middle Name:HANNA
Authorized Official - Last Name:GIOFFRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-563-8000
Mailing Address - Street 1:2129 GENERAL BOOTH BLVD
Mailing Address - Street 2:117
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454
Mailing Address - Country:US
Mailing Address - Phone:757-563-8000
Mailing Address - Fax:
Practice Address - Street 1:2129 GENERAL BOOTH BLVD
Practice Address - Street 2:117
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5872
Practice Address - Country:US
Practice Address - Phone:757-563-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty