Provider Demographics
NPI:1881798536
Name:GERMAIN, SUZANNE SCHULTZ (DDS)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:SCHULTZ
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BRENDON WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1955
Mailing Address - Country:US
Mailing Address - Phone:317-873-6750
Mailing Address - Fax:317-873-6708
Practice Address - Street 1:55 BRENDON WAY STE 200
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1955
Practice Address - Country:US
Practice Address - Phone:317-873-6750
Practice Address - Fax:317-873-6708
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120098631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice