Provider Demographics
NPI:1093702797
Name:SCHOENBECK, PAUL C (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:SCHOENBECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:NH
Mailing Address - Zip Code:03581-3406
Mailing Address - Country:US
Mailing Address - Phone:603-466-3047
Mailing Address - Fax:603-466-5791
Practice Address - Street 1:22 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:NH
Practice Address - Zip Code:03581-1604
Practice Address - Country:US
Practice Address - Phone:603-466-5015
Practice Address - Fax:603-466-5791
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008536Medicaid