Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 8602 | MN |
NPI | 1003830712 |
---|---|
Provider Name | John Keith Schulte |
First Address | Maplewood, MN 55109-2662 |
Second Address | Maplewood, MN 55109-2662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |