MEDICARE: MR. WOLFGANG ANDREW SCHALLER 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	122300000X	Dentist	2000175085	MO

General Provider Information

NPI Number	:	1922138320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WOLFGANG ANDREW SCHALLER DDS

Provider Business Mailing Address
First Line	:	8672 N FLINTLOCK RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157
Country	:	US
Telephone Number	:	816-781-4600
Fax Number	:	816-781-4610

Provider Business Practice Location Address
First Line	:	8672 N FLINTLOCK RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157
Country	:	US
Telephone Number	:	816-781-4600
Fax Number	:	816-781-4610

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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