Provider Demographics
NPI:1164648747
Name:SCHLECHT, TIMOTHY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:A
Last Name:SCHLECHT
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 1:981 E TUOLUMNE RD
Mailing Address - Street 2:110
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1544
Mailing Address - Country:US
Mailing Address - Phone:209-667-5405
Mailing Address - Fax:
Practice Address - Street 1:981 E TUOLUMNE RD
Practice Address - Street 2:110
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1544
Practice Address - Country:US
Practice Address - Phone:209-667-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO313791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice