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General NPI Number Information
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NPI Number | 1487428876
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Entity Type | Individual
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Provider Name | KRYSTALLE M. SCHUETZ RDH
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Gender | Female
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 5433 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53216-1382
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Country | US
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Telephone | 414-266-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 W COLD SPRING RD
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City | GREENFIELD
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State | WI
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Zip | 53221-1843
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Country | US
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Telephone | 414-882-0422
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 11551
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License Number State | WI
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