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General NPI Number Information
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NPI Number | 1407275613
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Entity Type | Organization
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Legal Business Name | SCHIECK ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 1531 CLINTON LN
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City | NORTHFIELD
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State | MN
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Zip | 55057-3295
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Country | US
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Telephone | 507-581-8575
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Fax | 507-216-6042
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Provider Business Mailing Address
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Address Line | 1531 CLINTON LN
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City | NORTHFIELD
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State | MN
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Zip | 55057-3295
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Country | US
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Telephone | 507-581-8575
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Fax | 507-216-6042
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACQUELYN SCHIECK
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Credential | DDS, MS
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Telephone | 507-581-8575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D13177
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License Number State | MN
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