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General NPI Number Information
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NPI Number | 1972762466
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Entity Type | Individual
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Provider Name | LEVI LYNN SCHANTZ DDS
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 550 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4748
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Country | US
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Telephone | 616-776-2421
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Fax |
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Provider Business Mailing Address
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Address Line | 7475 S M 66 HWY
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City | NASHVILLE
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State | MI
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Zip | 49073-9425
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Country | US
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Telephone | 517-852-2236
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901019837
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License Number State | MI
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