Healthcare Provider Details

I. General information

NPI: 1295714004
Provider Name (Legal Business Name): LORETTA ANN SCHUELER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 LIBERTY RD SUITE 101
ELDERSBURG MD
21784-7941
US

IV. Provider business mailing address

1981 TURNBERRY CT
FINKSBURG MD
21048-1561
US

V. Phone/Fax

Practice location:
  • Phone: 410-552-5230
  • Fax: 410-552-5231
Mailing address:
  • Phone: 612-384-9270
  • Fax: 410-861-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11742
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: