Provider Demographics
NPI:1003938408
Name:SCHULZE, GEORGE PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PETER
Last Name:SCHULZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 LORRAINE CT
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3214
Mailing Address - Country:US
Mailing Address - Phone:707-433-6907
Mailing Address - Fax:707-433-9030
Practice Address - Street 1:704 HEALDSBURG AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3651
Practice Address - Country:US
Practice Address - Phone:707-433-6907
Practice Address - Fax:707-433-9030
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD19968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist