Provider Demographics
NPI:1730200346
Name:SCHULZ, DOUGLAS M (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:M
Last Name:SCHULZ
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 1:6700 W 121ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2027
Mailing Address - Country:US
Mailing Address - Phone:913-649-3313
Mailing Address - Fax:913-906-0800
Practice Address - Street 1:6700 W 121ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2027
Practice Address - Country:US
Practice Address - Phone:913-649-3313
Practice Address - Fax:913-906-0800
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS58371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice