Provider Demographics
NPI:1225177413
Name:SCHULTZ, DAVID BRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:SCHULTZ
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:P.O. BOX 14227
Mailing Address - Street 2:WESTERN DENTAL SERVICES, INC.
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863
Mailing Address - Country:US
Mailing Address - Phone:714-571-3621
Mailing Address - Fax:714-571-3689
Practice Address - Street 1:530 SOUTH MAIN STREET
Practice Address - Street 2:WESTERN DENTAL SERVICES, INC.
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869
Practice Address - Country:US
Practice Address - Phone:714-571-3621
Practice Address - Fax:714-571-3689
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31701122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist