Provider Demographics
NPI:1184729196
Name:SCHAU, JENNIFER MARY BREWER (DDS)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARY BREWER
Last Name:SCHAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5545 COLONY DR N
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-7188
Mailing Address - Country:US
Mailing Address - Phone:989-799-0675
Mailing Address - Fax:989-799-0695
Practice Address - Street 1:5545 COLONY DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-7188
Practice Address - Country:US
Practice Address - Phone:989-799-0675
Practice Address - Fax:989-799-0695
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3296991Medicaid