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General NPI Number Information
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NPI Number | 1467593244
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Entity Type | Individual
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Provider Name | MYRON ROLAND STRASSER JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1429 COLLEGE AVE SUITE J
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City | MODESTO
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State | CA
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Zip | 95350-4057
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Country | US
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Telephone | 209-529-8872
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Fax | 209-571-0808
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Provider Business Mailing Address
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Address Line | 1429 COLLEGE AVE SUITE J
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City | MODESTO
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State | CA
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Zip | 95350-4057
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Country | US
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Telephone | 209-529-8872
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Fax | 209-571-0808
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 38604
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License Number State | CA
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