Provider Demographics
NPI:1952602013
Name:GREGORY S. STRAIN DDS, FAMILY DENTISTRY
Entity Type:Organization
Organization Name:GREGORY S. STRAIN DDS, FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:STRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-838-8118
Mailing Address - Street 1:1232 BEVERLY GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1904
Mailing Address - Country:US
Mailing Address - Phone:504-835-7839
Mailing Address - Fax:
Practice Address - Street 1:3108 W ESPLANADE AVE N
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1750
Practice Address - Country:US
Practice Address - Phone:504-838-8118
Practice Address - Fax:504-837-3263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4380122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty