Provider Demographics
NPI:1356503650
Name:SCHLISSEL, SUE D (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:D
Last Name:SCHLISSEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 N WASHINGTON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4252
Mailing Address - Country:US
Mailing Address - Phone:941-955-7344
Mailing Address - Fax:941-955-7944
Practice Address - Street 1:560 N WASHINGTON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4252
Practice Address - Country:US
Practice Address - Phone:941-955-7344
Practice Address - Fax:941-955-7944
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN90281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice