Individual
DR. TODD ALAN SCHULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7079
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.027715
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.027715
IL
Other
Enumeration date
08/21/2009
Last updated
09/28/2015
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