Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 12008141A | IN |
NPI | 1063431468 |
---|---|
Provider Name | Dr. Terry G. Schechner |
First Address | Valparaiso, IN 46385-8942 |
Second Address | Highland, IN 46322-1924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130765 | UNITED CONCORDIA (01) | IN |
755187 | UNITED CONCORDIA (01) | IN |