Provider Demographics
NPI:1881719631
Name:SCHULTZTOMS LLC
Entity type:Organization
Organization Name:SCHULTZTOMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEV
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-475-7188
Mailing Address - Street 1:611 SE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1506
Mailing Address - Country:US
Mailing Address - Phone:541-475-7188
Mailing Address - Fax:541-475-6159
Practice Address - Street 1:611 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1506
Practice Address - Country:US
Practice Address - Phone:541-475-7188
Practice Address - Fax:541-475-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty