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General NPI Number Information
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NPI Number | 1265439350
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Entity Type | Individual
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Provider Name | BARRY ROBERT STROMBERG DOS
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 13961 60TH ST N
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City | STILLWATER
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State | MN
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Zip | 55082-1053
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Country | US
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Telephone | 651-439-2600
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Fax | 651-439-2211
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Provider Business Mailing Address
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Address Line | 13961 60TH ST N
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City | STILLWATER
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State | MN
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Zip | 55082-1053
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Country | US
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Telephone | 651-439-2600
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Fax | 651-439-2211
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0005146
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License Number State | WI
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