Provider Demographics
NPI:1740393826
Name:SCHUSTER, TED A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:A
Last Name:SCHUSTER
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 1:1410 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2329
Mailing Address - Country:US
Mailing Address - Phone:330-332-8585
Mailing Address - Fax:330-332-9320
Practice Address - Street 1:1410 E STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2329
Practice Address - Country:US
Practice Address - Phone:330-332-8585
Practice Address - Fax:330-332-9320
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH206541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice