Healthcare Provider Details

I. General information

NPI: 1720104714
Provider Name (Legal Business Name): ROBERT GEORGE SCHUSTER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14168 DANVILLE PIKE
LAUREL FORK VA
24352-0068
US

IV. Provider business mailing address

279 OAK KNOLL DR
HILLSVILLE VA
24343-1739
US

V. Phone/Fax

Practice location:
  • Phone: 276-398-2588
  • Fax:
Mailing address:
  • Phone: 276-728-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401006721
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: