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General NPI Number Information
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NPI Number | 1790905289
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Entity Type | Organization
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Legal Business Name | PETER J SCHINDELHOLZ, DDS SC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 4453 COUNTY ROAD B
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City | LAND O LAKES
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State | WI
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Zip | 54540-9705
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Country | US
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Telephone | 715-547-3541
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Fax | 715-547-6659
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Provider Business Mailing Address
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Address Line | 4453 COUNTY ROAD B
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City | LAND O LAKES
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State | WI
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Zip | 54540-9705
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Country | US
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Telephone | 715-547-3541
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Fax | 715-547-6659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER J SCHINDELHOLZ
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Credential | DDS
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Telephone | 715-547-3541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2331
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License Number State | WI
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