Provider Demographics
NPI:1497857924
Name:SCHEUNEMANN, PAUL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:SCHEUNEMANN
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 1:332 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2136
Mailing Address - Country:US
Mailing Address - Phone:262-673-6050
Mailing Address - Fax:
Practice Address - Street 1:332 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-2136
Practice Address - Country:US
Practice Address - Phone:262-673-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2698-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice