Provider Demographics
NPI:1285779934
Name:STRAGIER, DANIEL EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWARD
Last Name:STRAGIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 GENESEE AVE
Mailing Address - Street 2:#202
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4940
Mailing Address - Country:US
Mailing Address - Phone:858-541-1844
Mailing Address - Fax:
Practice Address - Street 1:4340 GENESEE AVE
Practice Address - Street 2:#202
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4940
Practice Address - Country:US
Practice Address - Phone:858-541-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-0577813OtherCORPORATION ID #