Provider Demographics
NPI:1407867237
Name:SCHULTZ, JEFFREY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:SCHULTZ
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 1:9310 OLD KINGS RD S
Mailing Address - Street 2:BLDG. 601
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6152
Mailing Address - Country:US
Mailing Address - Phone:904-737-8081
Mailing Address - Fax:904-737-3343
Practice Address - Street 1:9310 OLD KINGS RD S
Practice Address - Street 2:BLDG. 601
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6152
Practice Address - Country:US
Practice Address - Phone:904-737-8081
Practice Address - Fax:904-737-3343
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN109741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice