Provider Demographics
NPI:1801903901
Name:SCHULTZ, JAMES TODD (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TODD
Last Name:SCHULTZ
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 1:26206 WEST TWELVE MILE ROAD
Mailing Address - Street 2:STE 104
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:248-827-1220
Mailing Address - Fax:248-827-8180
Practice Address - Street 1:26206 WEST TWELVE MILE ROAD
Practice Address - Street 2:STE 104
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-827-1220
Practice Address - Fax:248-827-8180
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010132661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice