Provider Demographics
NPI:1275539108
Name:SCHUBERT, DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SCHUBERT
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 1:24402 W LOCKPORT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-4206
Mailing Address - Country:US
Mailing Address - Phone:815-577-0700
Mailing Address - Fax:815-577-9670
Practice Address - Street 1:24402 W LOCKPORT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-4206
Practice Address - Country:US
Practice Address - Phone:815-577-0700
Practice Address - Fax:815-577-9670
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A149771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice