Healthcare Provider Details

I. General information

NPI: 1558617985
Provider Name (Legal Business Name): SCHUYLER BRENT SESSIONS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 3703 RM 205
APO AE
09180
US

IV. Provider business mailing address

BLDG 3703 RM. 205
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 06371929130
  • Fax:
Mailing address:
  • Phone: 06371929130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4434
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: