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General NPI Number Information
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NPI Number | 1518273200
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Entity Type | Individual
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Provider Name | JACQUELYN RAE SCHIECK DDS
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Gender | Female
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 05/12/2014
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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 |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | TEMP287
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License Number State | SD
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Taxonomy #2
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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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