Provider Demographics
NPI:1598103749
Name:SCHLOTTKE, SAE-EUN (DDS)
Entity type:Individual
Prefix:DR
First Name:SAE-EUN
Middle Name:
Last Name:SCHLOTTKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374MDG
Mailing Address - Street 2:UNIT 5071
Mailing Address - City:MUSASHIMURAYAMA
Mailing Address - State:YOKOTA AB
Mailing Address - Zip Code:APO AP 96328
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:374MDG
Practice Address - Street 2:UNIT 5071
Practice Address - City:MUSASHIMURAYAMA
Practice Address - State:YOKOTA AB
Practice Address - Zip Code:APO AP 96328
Practice Address - Country:JP
Practice Address - Phone:315-225-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0252661223P0700X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics