Provider Demographics
NPI:1699783860
Name:SCHUETTE, SALLY WALKER (DDS)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:WALKER
Last Name:SCHUETTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SALLY
Other - Middle Name:ANN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:14050 NICOLLET AVE SO
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5737
Mailing Address - Country:US
Mailing Address - Phone:952-435-4102
Mailing Address - Fax:952-435-8925
Practice Address - Street 1:7373 FRANCE AVE SO
Practice Address - Street 2:SUITE 402
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4598
Practice Address - Country:US
Practice Address - Phone:952-831-4400
Practice Address - Fax:952-893-3041
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN96691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry