Provider Demographics
NPI:1972508224
Name:SCHUSTER, ALLEN PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:PHILLIP
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 1:1112 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4309
Mailing Address - Country:US
Mailing Address - Phone:817-338-4444
Mailing Address - Fax:817-338-4461
Practice Address - Street 1:1112 S LAKE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4309
Practice Address - Country:US
Practice Address - Phone:817-338-4444
Practice Address - Fax:817-338-4461
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics