Healthcare Provider Details
I. General information
NPI: 1154660348
Provider Name (Legal Business Name): SCHUMACHER AND BAUER DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2013
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 OLENTANGY RIVER RD SUITE 500B
COLUMBUS OH
43214-3437
US
IV. Provider business mailing address
3600 OLENTANGY RIVER RD SUITE 500B
COLUMBUS OH
43214-3437
US
V. Phone/Fax
- Phone: 614-451-1110
- Fax: 614-451-9205
- Phone: 614-451-1110
- Fax: 614-451-9205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 124Q00000X |
| Taxonomy | Dental Hygienist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
SCHUMACHER
Title or Position: DENTIST
Credential: D.D.S.
Phone: 614-451-1110