Provider Demographics
NPI:1386796373
Name:STRAKA, JAMES BRIAN (DMD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:STRAKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 BRODHEAD RD
Mailing Address - Street 2:SUITE 184
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9201
Mailing Address - Country:US
Mailing Address - Phone:610-814-6277
Mailing Address - Fax:
Practice Address - Street 1:3005 BRODHEAD RD
Practice Address - Street 2:SUITE 184
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9201
Practice Address - Country:US
Practice Address - Phone:610-814-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO28985L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics