Provider Demographics
NPI:1285778506
Name:SCHELLBACH, WILLIAM H (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:SCHELLBACH
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 1:10724 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2313
Mailing Address - Country:US
Mailing Address - Phone:818-985-7171
Mailing Address - Fax:818-985-1514
Practice Address - Street 1:10724 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2313
Practice Address - Country:US
Practice Address - Phone:818-985-7171
Practice Address - Fax:818-985-1514
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice