Provider Demographics
NPI:1396960373
Name:SCHOFIELD, STUART R (DMD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:R
Last Name:SCHOFIELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:DOS PALOS
Mailing Address - State:CA
Mailing Address - Zip Code:93620-2321
Mailing Address - Country:US
Mailing Address - Phone:209-392-6166
Mailing Address - Fax:209-392-6172
Practice Address - Street 1:1402 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:DOS PALOS
Practice Address - State:CA
Practice Address - Zip Code:93620-2321
Practice Address - Country:US
Practice Address - Phone:209-392-6166
Practice Address - Fax:209-392-6172
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice