Provider Demographics
NPI:1376744284
Name:SCHUETTER, CHARLES F (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:SCHUETTER
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 1:4649 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1852
Mailing Address - Country:US
Mailing Address - Phone:502-429-8482
Mailing Address - Fax:
Practice Address - Street 1:4649 SHENANDOAH DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1852
Practice Address - Country:US
Practice Address - Phone:502-429-8482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY62141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice