Healthcare Provider Details

I. General information

NPI: 1598709222
Provider Name (Legal Business Name): LEROY PAUL SCHILD JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N1737 LILY OF THE VALLEY DR
GREENVILLE WI
54942-9066
US

IV. Provider business mailing address

W7283 WESTHAVEN
GREENVILLE WI
54942
US

V. Phone/Fax

Practice location:
  • Phone: 920-757-0100
  • Fax: 920-757-0200
Mailing address:
  • Phone: 920-757-0100
  • Fax: 920-757-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4952
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: