Provider Demographics
NPI:1306339155
Name:STROBEL, BENJAMIN LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LOUIS
Last Name:STROBEL
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 1:730 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3436
Mailing Address - Country:US
Mailing Address - Phone:920-585-0660
Mailing Address - Fax:
Practice Address - Street 1:9 TRI PARK WAY
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-1661
Practice Address - Country:US
Practice Address - Phone:920-882-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10018161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice