MEDICARE: DONALD W SCHIESS DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	37912	CA

General Provider Information

NPI Number	:	1063659100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD W SCHIESS DDS PC

Provider Business Mailing Address
First Line	:	39872 LOS ALAMOS RD
Second Line	:	SUITE A-1
City	:	MURRIETA
State	:	CA
Zip	:	92562-5871
Country	:	US
Telephone Number	:	951-698-8418
Fax Number	:

Provider Business Practice Location Address
First Line	:	39872 LOS ALAMOS RD
Second Line	:	SUITE A-1
City	:	MURRIETA
State	:	CA
Zip	:	92562-5871
Country	:	US
Telephone Number	:	951-698-8418
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD WILLIAM SCHIESS
Credential	:	D.D.S.
Telephone Number	:	951-698-8418

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	01/12/2009

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