Healthcare Provider Details

I. General information

NPI: 1174643316
Provider Name (Legal Business Name): WILLIAM S SCHACTER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 SE FEDERAL HWY
STUART FL
34994-5738
US

IV. Provider business mailing address

490 MARINER DR
JUPITER FL
33477-4068
US

V. Phone/Fax

Practice location:
  • Phone: 772-219-2224
  • Fax:
Mailing address:
  • Phone: 561-745-0626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN14659
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: