Provider Demographics
NPI:1689921058
Name:SCHUYLER, BENJAMIN PHILIP (DMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:PHILIP
Last Name:SCHUYLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5970 FAIRVIEW RD
Mailing Address - Street 2:STE 120
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-0098
Mailing Address - Country:US
Mailing Address - Phone:704-523-1462
Mailing Address - Fax:
Practice Address - Street 1:202 E WOODLAWN RD
Practice Address - Street 2:SUITE 144 B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2213
Practice Address - Country:US
Practice Address - Phone:704-523-1462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-05
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9383122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist