Provider Demographics
NPI:1194734848
Name:SCHLOTTMAN, DAVID EARL (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EARL
Last Name:SCHLOTTMAN
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 1:6349 HWY 550
Mailing Address - Street 2:PO BOX 638
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013
Mailing Address - Country:US
Mailing Address - Phone:505-289-3291
Mailing Address - Fax:505-289-3648
Practice Address - Street 1:6349 HWY. 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013
Practice Address - Country:US
Practice Address - Phone:505-289-3291
Practice Address - Fax:505-289-3648
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD24621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice