Provider Demographics
NPI:1760114813
Name:SCHILD, AUSTIN GREGORY (DMD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:GREGORY
Last Name:SCHILD
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 1:15795 ROBBINS RD
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-9517
Mailing Address - Country:US
Mailing Address - Phone:616-422-8301
Mailing Address - Fax:
Practice Address - Street 1:1221 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-1811
Practice Address - Country:US
Practice Address - Phone:231-638-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016014431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice