Provider Demographics
NPI:1003905886
Name:SCHULTZ, JEAN M (DDS MS)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:M
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1801 EAST SAGINAW STREET
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2383
Mailing Address - Country:US
Mailing Address - Phone:517-372-6450
Mailing Address - Fax:517-372-5020
Practice Address - Street 1:1801 EAST SAGINAW STREET
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2383
Practice Address - Country:US
Practice Address - Phone:517-372-6450
Practice Address - Fax:517-372-5020
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI0168781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics