Provider Demographics
NPI:1114942919
Name:SCHLEUSENER, DAVID REX (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:REX
Last Name:SCHLEUSENER
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 1:1980 SPRUCE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2684
Mailing Address - Country:US
Mailing Address - Phone:563-359-3533
Mailing Address - Fax:
Practice Address - Street 1:1980 SPRUCE HILLS DR
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2684
Practice Address - Country:US
Practice Address - Phone:563-359-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA12348864Medicaid