MEDICARE: SARA SCHULTZ DDS

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	D.0006655-C1	AL

General Provider Information

NPI Number	:	1568022887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA SCHULTZ DDS

Provider Business Mailing Address
First Line	:	1572 MILL SQ
Second Line	:
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-2674
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1572 MILL SQUARE
Second Line	:
City	:	ALEXANDER CITY
State	:	AL
Zip	:	35010-2674
Country	:	US
Telephone Number	:	256-397-1050
Fax Number	:

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

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	06/18/2019

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