Provider Demographics
NPI:1154801116
Name:CHADRON C SCHELL, LLC
Entity type:Organization
Organization Name:CHADRON C SCHELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHADRON
Authorized Official - Middle Name:CUTLER
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-613-1758
Mailing Address - Street 1:7201 RED HILLS RD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-6071
Mailing Address - Country:US
Mailing Address - Phone:402-613-1758
Mailing Address - Fax:
Practice Address - Street 1:805 S 4J RD
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4132
Practice Address - Country:US
Practice Address - Phone:307-682-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY12511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty