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General NPI Number Information
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NPI Number | 1871166637
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Entity Type | Individual
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Provider Name | ELIZABETH DIANA SCHEINTHAL DMD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 10618 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-5013
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Country | US
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Telephone | 262-241-0400
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Fax | 262-643-4272
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Provider Business Mailing Address
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Address Line | 777 N VAN BUREN ST APT 1613
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City | MILWAUKEE
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State | WI
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Zip | 53202-3861
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Country | US
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Telephone | 512-673-3196
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6001164-15
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License Number State | WI
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