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General NPI Number Information
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NPI Number | 1922145861
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Entity Type | Organization
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Legal Business Name | WILLIAM J. SCHULDT, D.D.S., P.A.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 324 W SUPERIOR ST SUITE 1229
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City | DULUTH
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State | MN
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Zip | 55802-1701
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Country | US
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Telephone | 218-722-7404
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Fax |
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Provider Business Mailing Address
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Address Line | 324 W SUPERIOR ST SUITE 1229
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City | DULUTH
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State | MN
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Zip | 55802-1701
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Country | US
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Telephone | 218-722-7404
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM JACK SCHULDT JR.
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Credential | D.D.S., M.S.
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Telephone | 218-722-7404
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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 | D8754
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License Number State | MN
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