MEDICARE: DR. STEPHEN M SCHOTT D.D.S. INC

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	1223G0001X	General Practice Dentistry	25837	CA

General Provider Information

NPI Number	:	1366511040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M SCHOTT D.D.S. INC

Provider Business Mailing Address
First Line	:	32322 COAST HWY
Second Line	:	SUITE A
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-6785
Country	:	US
Telephone Number	:	949-499-5344
Fax Number	:	949-499-0746

Provider Business Practice Location Address
First Line	:	32322 COAST HWY
Second Line	:	SUITE A
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-6785
Country	:	US
Telephone Number	:	949-499-5344
Fax Number	:	949-499-0746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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