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General NPI Number Information
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NPI Number | 1902050750
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Entity Type | Individual
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Provider Name | AUSTIN SCHELLINCK D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 1400 SANTA RITA RD SUITE B
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City | PLEASANTON
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State | CA
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Zip | 94566-5666
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Country | US
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Telephone | 925-398-8903
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Fax | 925-401-7013
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Provider Business Mailing Address
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Address Line | 1400 SANTA RITA RD SUITE B
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City | PLEASANTON
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State | CA
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Zip | 94566-5666
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Country | US
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Telephone | 925-398-8903
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Fax | 925-401-7013
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 58213
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License Number State | CA
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