MEDICARE: DR. ROBERT LEE STRAIN 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	122300000X	Dentist	23044	CA
2	122300000X	Dentist	D010293	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D010293	OTHER	AZ	ARIZONA BOARD OF DENTAL EXAMINERS

General Provider Information

NPI Number	:	1801924956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LEE STRAIN DDS

Provider Business Mailing Address
First Line	:	1636 MORNING STONE DR
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-1101
Country	:	US
Telephone Number	:	714-292-5238
Fax Number	:	760-418-8270

Provider Business Practice Location Address
First Line	:	1227 WILLOW CREEK RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86301-1427
Country	:	US
Telephone Number	:	928-778-7227
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	06/17/2019

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