Provider Demographics
NPI:1164942777
Name:SCHOETTLER, CAMERON JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:JAMES
Last Name:SCHOETTLER
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 1:1140 CHANTILLY COMMONS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-5454
Mailing Address - Country:US
Mailing Address - Phone:404-234-1433
Mailing Address - Fax:
Practice Address - Street 1:5252 ROSWELL RD STE 105
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1969
Practice Address - Country:US
Practice Address - Phone:404-252-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1222911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice