Provider Demographics
NPI:1295716140
Name:SCHULTE, CAROL EILEEN
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:EILEEN
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:EILEEN
Other - Last Name:SCHOEWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2381 RICE ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3715
Mailing Address - Country:US
Mailing Address - Phone:651-490-1200
Mailing Address - Fax:
Practice Address - Street 1:2381 RICE ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3715
Practice Address - Country:US
Practice Address - Phone:651-490-1200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN27881SCOtherBLUE CROSS BLUE SHIELD
MN1873OtherHEALTH PARTNERS