Provider Demographics
NPI:1194944678
Name:SCHLUTZ, DAVID S (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:SCHLUTZ
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 1:4618 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2255
Mailing Address - Country:US
Mailing Address - Phone:301-770-7369
Mailing Address - Fax:301-770-7631
Practice Address - Street 1:4618 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2255
Practice Address - Country:US
Practice Address - Phone:301-770-7369
Practice Address - Fax:301-770-7631
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice