MEDICARE: DR. RACHEL A. SCHALLHORN D.D.S., M.S.

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	1223P0300X	Periodontics	9882	CO

General Provider Information

NPI Number	:	1518141936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL A. SCHALLHORN D.D.S., M.S.

Provider Business Mailing Address
First Line	:	11200 E MISSISSIPPI AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-3260
Country	:	US
Telephone Number	:	303-696-7885
Fax Number	:

Provider Business Practice Location Address
First Line	:	7703 FLOYD CURL DR
Second Line	:	MSC 7894
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3901
Country	:	US
Telephone Number	:	210-567-3589
Fax Number	:	210-567-3761

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

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	06/10/2009

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