Provider Demographics
NPI:1275995268
Name:SCHULKE, YVONNE (DMD)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:SCHULKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16431 N 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-1004
Mailing Address - Country:US
Mailing Address - Phone:920-544-6704
Mailing Address - Fax:
Practice Address - Street 1:3103 HUMMINGBIRD RD
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-6311
Practice Address - Country:US
Practice Address - Phone:715-845-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIIN PROCESS122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist