Healthcare Provider Details
I. General information
NPI: 1508079815
Provider Name (Legal Business Name): PATRICK J. STROH, D.D.S., M.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
827 DEEP VALLEY DR SUITE 200
ROLLING HILLS ESTATES CA
90274-3647
US
IV. Provider business mailing address
827 DEEP VALLEY DR SUITE 200
ROLLING HILLS ESTATES CA
90274-3647
US
V. Phone/Fax
- Phone: 310-377-7777
- Fax:
- Phone: 310-377-7777
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PATRICK
JAMES
STROH
Title or Position: OWNER
Credential: D.D.S, M.S.
Phone: 310-377-7777