Provider Demographics
NPI:1396840005
Name:SCHELLER, STEVEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:SCHELLER
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 1:4001 GEIST RD STE 12
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3569
Mailing Address - Country:US
Mailing Address - Phone:907-452-7955
Mailing Address - Fax:
Practice Address - Street 1:4001 GEIST RD STE 12
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3569
Practice Address - Country:US
Practice Address - Phone:907-452-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3534122300000X
AKAK1022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist