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General NPI Number Information
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NPI Number | 1467882654
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Entity Type | Organization
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Legal Business Name | DR. MICHAEL W. SCHULTE
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 623 GARRISONVILLE RD
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City | STAFFORD
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State | VA
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Zip | 22554-3710
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Country | US
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Telephone | 540-659-6650
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Fax | 540-657-0576
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Provider Business Mailing Address
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Address Line | PO BOX 279 623 GARRISONVILLE ROAD
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City | STAFFORD
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State | VA
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Zip | 22555-0279
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Country | US
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Telephone | 540-659-6650
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Fax | 540-657-0576
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Authorized Official
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Title or Position | DENTISIT /OWNER
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Name | DR. MICHAEL WILLIAM SCHULTE
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Credential | D.D.S.
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Telephone | 540-659-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401005624
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 040413627
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License Number State | VA
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