Provider Demographics
NPI:1568413938
Name:JOHN F. SCHONDELMAYER, D.D.S., PC
Entity Type:Organization
Organization Name:JOHN F. SCHONDELMAYER, D.D.S., PC
Other - Org Name:WHITE CLOUD FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:SCHONDELMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-689-6651
Mailing Address - Street 1:1033 E WILCOX AVE
Mailing Address - Street 2:P.O. BOX 667
Mailing Address - City:WHITE CLOUD
Mailing Address - State:MI
Mailing Address - Zip Code:49349-8794
Mailing Address - Country:US
Mailing Address - Phone:231-689-6651
Mailing Address - Fax:231-689-5820
Practice Address - Street 1:1033 E WILCOX AVE
Practice Address - Street 2:
Practice Address - City:WHITE CLOUD
Practice Address - State:MI
Practice Address - Zip Code:49349-8794
Practice Address - Country:US
Practice Address - Phone:231-689-6651
Practice Address - Fax:231-689-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010130531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty