MEDICARE: PAUL M SCHOLL D.D.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	1223G0001X	General Practice Dentistry	5001832	WI

General Provider Information

NPI Number	:	1922001916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL M SCHOLL D.D.S

Provider Business Mailing Address
First Line	:	2544 N 91ST ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-1835
Country	:	US
Telephone Number	:	414-774-8948
Fax Number	:

Provider Business Practice Location Address
First Line	:	9211 W AUER AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3528
Country	:	US
Telephone Number	:	414-445-3670
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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