Provider Demographics
NPI:1598709222
Name:SCHILD, LEROY PAUL JR (DDS)
Entity Type:Individual
Prefix:
First Name:LEROY
Middle Name:PAUL
Last Name:SCHILD
Suffix:JR
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:W7283 WESTHAVEN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942
Mailing Address - Country:US
Mailing Address - Phone:920-757-0100
Mailing Address - Fax:920-757-0200
Practice Address - Street 1:N1737 LILY OF THE VALLEY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-9066
Practice Address - Country:US
Practice Address - Phone:920-757-0100
Practice Address - Fax:920-757-0200
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4952OtherLICENSE