Provider Demographics
NPI:1992820112
Name:STRAUB, JEFFREY LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LOUIS
Last Name:STRAUB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:W178N9201 WATER TOWER PLACE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051
Mailing Address - Country:US
Mailing Address - Phone:262-251-8704
Mailing Address - Fax:262-251-8341
Practice Address - Street 1:W178N9201 WATER TOWER PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051
Practice Address - Country:US
Practice Address - Phone:262-251-8704
Practice Address - Fax:262-251-8341
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics