Provider Demographics
NPI:1922138320
Name:SCHALLER, WOLFGANG ANDREW (DDS)
Entity Type:Individual
Prefix:MR
First Name:WOLFGANG
Middle Name:ANDREW
Last Name:SCHALLER
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 1:8672 N FLINTLOCK RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157
Mailing Address - Country:US
Mailing Address - Phone:816-781-4600
Mailing Address - Fax:816-781-4610
Practice Address - Street 1:8672 N FLINTLOCK RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157
Practice Address - Country:US
Practice Address - Phone:816-781-4600
Practice Address - Fax:816-781-4610
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000175085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist