Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 6127 | FL |
NPI | 1003922980 |
---|---|
Provider Name | Dr. Daniel Joseph Schellhase |
First Address | Jacksonville, FL 32210-8435 |
Second Address | Jacksonville, FL 32210-8435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 25/03/2010 |