Healthcare Provider Details

I. General information

NPI: 1427551266
Provider Name (Legal Business Name): VALERIE SCHILLER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 PLEASANT ST
WORCESTER MA
01602-1266
US

IV. Provider business mailing address

21 SOUTH ST
PAXTON MA
01612-1213
US

V. Phone/Fax

Practice location:
  • Phone: 508-797-9708
  • Fax:
Mailing address:
  • Phone: 508-757-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN15796
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: