Healthcare Provider Details

I. General information

NPI: 1083721955
Provider Name (Legal Business Name): STRAUSS & STRAUSS D.M.D.S, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 E OCEAN BLVD SUITE A
STUART FL
34994-2456
US

IV. Provider business mailing address

821 SE OCEAN BLVD SUITE A
STUART FL
34994-2456
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-6757
  • Fax: 772-283-8701
Mailing address:
  • Phone: 772-283-6757
  • Fax: 772-283-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. SORRELL IZEN STRAUSS
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 772-283-6757