Healthcare Provider Details
I. General information
NPI: 1659334894
Provider Name (Legal Business Name): MICHAEL STRASSBERG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2006
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 WASHINGTON ST
TOMS RIVER NJ
08753-7643
US
IV. Provider business mailing address
16 WASHINGTON ST
TOMS RIVER NJ
08753-7643
US
V. Phone/Fax
- Phone: 732-914-1039
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | 014811 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: