Healthcare Provider Details

I. General information

NPI: 1487643136
Provider Name (Legal Business Name): THOMAS JOSEPH SCHOEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MAIN ST W
WABASHA MN
55981-1238
US

IV. Provider business mailing address

257 MAIN ST W PO BOX 128
WABASHA MN
55981-1238
US

V. Phone/Fax

Practice location:
  • Phone: 651-565-4647
  • Fax: 651-565-2899
Mailing address:
  • Phone: 651-565-4647
  • Fax: 651-565-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9378
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: