Provider Demographics
NPI:1316047616
Name:SCHOONMAKER, DEVIN PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:PAUL
Last Name:SCHOONMAKER
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 1:1400 W GARY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3238
Mailing Address - Country:US
Mailing Address - Phone:580-323-7733
Mailing Address - Fax:
Practice Address - Street 1:1400 W GARY BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3238
Practice Address - Country:US
Practice Address - Phone:580-323-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice