MEDICARE: DR. NORMAN C. STRAKER DDS.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	15547	OH

General Provider Information

NPI Number	:	1467672444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN C. STRAKER DDS.

Provider Business Mailing Address
First Line	:	10401 SAWMILL PKWY
Second Line	:	SUITE D-100
City	:	POWELL
State	:	OH
Zip	:	43065-7451
Country	:	US
Telephone Number	:	614-792-0064
Fax Number	:	614-792-3376

Provider Business Practice Location Address
First Line	:	10401 SAWMILL PKWY
Second Line	:	SUITE D-100
City	:	POWELL
State	:	OH
Zip	:	43065-7451
Country	:	US
Telephone Number	:	614-792-0064
Fax Number	:	614-792-3376

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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