Provider Demographics
NPI:1457453995
Name:SCHULTZ, MARLENE M. MARTHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARLENE M.
Middle Name:MARTHA
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MARLENE M.
Other - Middle Name:
Other - Last Name:WALENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MARLENE M SCHULTZ
Mailing Address - Street 1:973 MANHATTAN BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5131
Mailing Address - Country:US
Mailing Address - Phone:310-545-4509
Mailing Address - Fax:310-545-4769
Practice Address - Street 1:973 MANHATTAN BEACH BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5131
Practice Address - Country:US
Practice Address - Phone:310-545-4509
Practice Address - Fax:310-545-4769
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA182661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice