Provider Demographics
NPI:1568351989
Name:SCHOLL, JUSTIN ROBERT (RDH, RDA)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:ROBERT
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:RDH, RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BIRCH ST N STE 114
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1507
Mailing Address - Country:US
Mailing Address - Phone:763-347-4399
Mailing Address - Fax:
Practice Address - Street 1:140 BIRCH ST N STE 114
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1507
Practice Address - Country:US
Practice Address - Phone:763-347-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH7756124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist