Healthcare Provider Details

I. General information

NPI: 1073715660
Provider Name (Legal Business Name): DR GEORGE J SCHUETZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 PALMER COURT
WILDER VT
05088
US

IV. Provider business mailing address

PO BOX 429
WILDER VT
05088-0429
US

V. Phone/Fax

Practice location:
  • Phone: 802-649-8277
  • Fax: 802-649-8484
Mailing address:
  • Phone: 802-649-8277
  • Fax: 802-649-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number016-0000537
License Number StateVT

VIII. Authorized Official

Name: DR. GEORGE JAMES SCHUETZ
Title or Position: OWNER
Credential: DDS, MS
Phone: 802-649-8277