Healthcare Provider Details

I. General information

NPI: 1295716140
Provider Name (Legal Business Name): CAROL EILEEN SCHULTE
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: CAROL EILEEN SCHOEWE DDS

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2381 RICE ST
ROSEVILLE MN
55113-3715
US

IV. Provider business mailing address

2381 RICE ST
ROSEVILLE MN
55113-3715
US

V. Phone/Fax

Practice location:
  • Phone: 651-490-1200
  • Fax:
Mailing address:
  • Phone: 651-490-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8188
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: