MEDICARE: STUART R SCHOFIELD DMD

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	1223G0001X	General Practice Dentistry	41306	CA

General Provider Information

NPI Number	:	1396960373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART R SCHOFIELD DMD

Provider Business Mailing Address
First Line	:	1402 CALIFORNIA AVE
Second Line	:
City	:	DOS PALOS
State	:	CA
Zip	:	93620-2321
Country	:	US
Telephone Number	:	209-392-6166
Fax Number	:	209-392-6172

Provider Business Practice Location Address
First Line	:	1402 CALIFORNIA AVE
Second Line	:
City	:	DOS PALOS
State	:	CA
Zip	:	93620-2321
Country	:	US
Telephone Number	:	209-392-6166
Fax Number	:	209-392-6172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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Directions to “ STUART R SCHOFIELD DMD” Practice Location

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