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General NPI Number Information
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NPI Number | 1053337410
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Entity Type | Individual
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Provider Name | ROSS W STRYKER DDS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 590 LYNN ST
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City | LEBANON
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State | MO
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Zip | 65536-2409
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Country | US
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Telephone | 417-532-9532
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Fax | 417-532-9526
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Provider Business Mailing Address
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Address Line | PO BOX 1193
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City | LEBANON
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State | MO
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Zip | 65536-1193
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Country | US
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Telephone | 417-532-9532
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Fax | 417-532-9526
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 013809
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License Number State | MO
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