Healthcare Provider Details

I. General information

NPI: 1316034895
Provider Name (Legal Business Name): ROBERT ARTHUR STRATHMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15421 CLAYTON RD STE 203
BALLWIN MO
63011-3161
US

IV. Provider business mailing address

2141 HUNTERS WAY CT
CHESTERFIELD MO
63017-5025
US

V. Phone/Fax

Practice location:
  • Phone: 636-394-9177
  • Fax: 636-394-6911
Mailing address:
  • Phone: 636-519-9504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number14135
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: