Provider Demographics
NPI:1215083415
Name:SCHUSTER, JOHN RAYMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RAYMOND
Last Name:SCHUSTER
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 1:7925 MUNSON RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:MENTOR ON THE LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44060-3743
Mailing Address - Country:US
Mailing Address - Phone:440-257-9142
Mailing Address - Fax:440-257-9132
Practice Address - Street 1:7925 MUNSON RD
Practice Address - Street 2:SUITE #2
Practice Address - City:MENTOR ON THE LAKE
Practice Address - State:OH
Practice Address - Zip Code:44060-3743
Practice Address - Country:US
Practice Address - Phone:440-257-9142
Practice Address - Fax:440-257-9132
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice