Provider Demographics
NPI:1841479854
Name:SCHELENZ, ROLAND E (DDS)
Entity type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:E
Last Name:SCHELENZ
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 1:70 DAILY DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5803
Mailing Address - Country:US
Mailing Address - Phone:805-987-7671
Mailing Address - Fax:805-987-5759
Practice Address - Street 1:70 DAILY DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-5803
Practice Address - Country:US
Practice Address - Phone:805-987-7671
Practice Address - Fax:805-987-5759
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice