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NPI Code Detail

MEDICARE: TIMOTHY A. SCHAIBLE P.C.

MEDICARE: TIMOTHY A. SCHAIBLE P.C.
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 Dentistry14957MO

General Provider Information

NPI Number : 1508993510
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIMOTHY A. SCHAIBLE P.C.
Provider Business Mailing Address
First Line : 1544 SIERRA VISTA PLZ
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63138-2040
Country : US
Telephone Number : 314-355-5700
Fax Number : 314-355-5702
Provider Business Practice Location Address
First Line : 1544 SIERRA VISTA PLZ
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63138-2040
Country : US
Telephone Number : 314-355-5700
Fax Number : 314-355-5702
Authorized Official
Title or Position : PRESIDENT
Name : DR. TIMOTHY ALTON SCHAIBLE
Credential : DMD
Telephone Number : 314-355-5700
Provider Enumeration Date : 02/27/2007
Last Update Date : 02/27/2008

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Directions to “TIMOTHY A. SCHAIBLE P.C. ” Practice Location

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