=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669022927
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROD STROBER DDS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2019
-----------------------------------------------------
Last Update Date | 09/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 72775 FRANK SINATRA DR STE B
-----------------------------------------------------
City | RANCHO MIRAGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92270-3229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-832-7915
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1054 VIA FORTUNA
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-873-6699
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ROD H STROBER
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 619-873-6699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------