Provider Demographics
NPI:1073715660
Name:DR GEORGE J SCHUETZ
Entity Type:Organization
Organization Name:DR GEORGE J SCHUETZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHUETZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:802-649-8277
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:VT
Mailing Address - Zip Code:05088-0429
Mailing Address - Country:US
Mailing Address - Phone:802-649-8277
Mailing Address - Fax:802-649-8484
Practice Address - Street 1:144 PALMER COURT
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:VT
Practice Address - Zip Code:05088
Practice Address - Country:US
Practice Address - Phone:802-649-8277
Practice Address - Fax:802-649-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-0000537122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty