Provider Demographics
NPI:1588768014
Name:DANIEL L SCHAUT SC
Entity type:Organization
Organization Name:DANIEL L SCHAUT SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHAUT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-359-6536
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:5225 PINE ST
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-0317
Mailing Address - Country:US
Mailing Address - Phone:715-359-6536
Mailing Address - Fax:715-355-6195
Practice Address - Street 1:5225 PINE ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-0317
Practice Address - Country:US
Practice Address - Phone:715-359-6536
Practice Address - Fax:715-355-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1313G122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty