MEDICARE: N&M DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1033675871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N&M DDS

Provider Business Mailing Address
First Line	:	4157 40TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3444
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	483 BRIMHALL ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1508
Country	:	US
Telephone Number	:	651-698-0848
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. NICHOLAS SCHULTE
Credential	:	DDS
Telephone Number	:	320-492-0300

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	02/18/2019

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