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NPI Code Detail

MEDICARE: GLENN ROBERT SHEUMAKER D.D.S.

MEDICARE: GLENN ROBERT SHEUMAKER D.D.S.
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
11223G0001XGeneral Practice Dentistry8379FL

General Provider Information

NPI Number : 1285654046
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN ROBERT SHEUMAKER D.D.S.
Provider Business Mailing Address
First Line : 6731 US HIGHWAY 98 N
Second Line :
City : LAKELAND
State : FL
Zip : 33809-6226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6731 US HIGHWAY 98 N
Second Line :
City : LAKELAND
State : FL
Zip : 33809-6226
Country : US
Telephone Number : 863-850-3043
Fax Number : 863-853-8135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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