Provider Demographics
NPI:1114076106
Name:SCHIPPERS, DOULGAS J (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:DOULGAS
Middle Name:J
Last Name:SCHIPPERS
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 MICHIGAN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4911
Mailing Address - Country:US
Mailing Address - Phone:616-396-1238
Mailing Address - Fax:616-396-3045
Practice Address - Street 1:577 MICHIGAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4911
Practice Address - Country:US
Practice Address - Phone:616-396-1238
Practice Address - Fax:616-396-3045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI135071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics