Organization
80TH AVE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A STRAUMAN DDS (PRESIDENT)
(708) 429-3504
Entity
Organization
Contact information
Practice address
16717 80TH AVE, TINLEY PARK, IL 60477-2361
(708) 429-3504
(708) 429-5667
Mailing address
16717 80TH AVE, TINLEY PARK, IL 60477-2361
(708) 429-3504
(708) 429-5667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019016658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06126
BCBS
NY
01
—
CB621
BCBS
IL
01
—
CBAL1
BCBS
AL
01
—
CBAR1
BCBS
AR
01
—
CBFL1
BCBS
FL
01
—
CBMI1
BCBS
MI
01
—
SP601
BCBS
CA
Enumeration date
11/07/2006
Last updated
07/08/2008
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