Provider Demographics
NPI:1578605457
Name:SCHLAEBITZ, BRUCE PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:PATRICK
Last Name:SCHLAEBITZ
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:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:HOOPER
Mailing Address - State:NE
Mailing Address - Zip Code:68031-0423
Mailing Address - Country:US
Mailing Address - Phone:402-654-2539
Mailing Address - Fax:
Practice Address - Street 1:600 E FULTON
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:NE
Practice Address - Zip Code:68031-0423
Practice Address - Country:US
Practice Address - Phone:402-654-2539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice