Provider Demographics
NPI:1831367838
Name:SCHULTZ, BARTHOLEMEW (DDS)
Entity type:Individual
Prefix:DR
First Name:BARTHOLEMEW
Middle Name:
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 1:4300 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2025
Mailing Address - Country:US
Mailing Address - Phone:952-894-2545
Mailing Address - Fax:952-894-2595
Practice Address - Street 1:4300 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2025
Practice Address - Country:US
Practice Address - Phone:952-894-2545
Practice Address - Fax:952-894-2595
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND112561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice