Provider Demographics
NPI:1710540380
Name:SCHUSTER DENTAL GROUP
Entity Type:Organization
Organization Name:SCHUSTER DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-209-6388
Mailing Address - Street 1:1500 SCOTT ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 SCOTT ST
Practice Address - Street 2:STE 100
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454
Practice Address - Country:US
Practice Address - Phone:469-209-6388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1457790685OtherNPPES