Healthcare Provider Details

I. General information

NPI: 1487876470
Provider Name (Legal Business Name): PATRICK JAMES STROH D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 DEEP VALLEY DRIVE SUITE 200
ROLLING HILLS ESTATES CA
90274
US

IV. Provider business mailing address

827 DEEP VALLEY DRIVE SUITE 200
ROLLING HILLS ESTATES CA
90274
US

V. Phone/Fax

Practice location:
  • Phone: 310-377-7777
  • Fax:
Mailing address:
  • Phone: 310-377-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number38367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: