Provider Demographics
NPI:1295897056
Name:SCHLAACK, DAVID M (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:SCHLAACK
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 1:11 CROSSROADS COURT
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018
Mailing Address - Country:US
Mailing Address - Phone:262-646-4188
Mailing Address - Fax:262-646-4181
Practice Address - Street 1:11 CROSSROADS CT
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2035
Practice Address - Country:US
Practice Address - Phone:262-646-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist