Provider Demographics
NPI:1588426613
Name:SCHULTZ FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:SCHULTZ FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-353-0900
Mailing Address - Street 1:5400 WALSH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2859
Mailing Address - Country:US
Mailing Address - Phone:314-353-0900
Mailing Address - Fax:314-353-1018
Practice Address - Street 1:5400 WALSH ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2859
Practice Address - Country:US
Practice Address - Phone:314-353-0900
Practice Address - Fax:314-353-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies