Provider Demographics
NPI:1700446010
Name:SCHUYLER, KURTIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:
Last Name:SCHUYLER
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 1:416 ELM ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-2352
Mailing Address - Country:US
Mailing Address - Phone:314-239-2273
Mailing Address - Fax:
Practice Address - Street 1:416 ELM ST STE 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-2352
Practice Address - Country:US
Practice Address - Phone:636-239-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019021350122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty