Provider Demographics
NPI:1255347795
Name:SCHEULE, STEVEN RAYMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAYMOND
Last Name:SCHEULE
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 1:54 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-1418
Mailing Address - Country:US
Mailing Address - Phone:856-769-0505
Mailing Address - Fax:856-769-0751
Practice Address - Street 1:54 EAST AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1418
Practice Address - Country:US
Practice Address - Phone:856-769-0505
Practice Address - Fax:856-769-0751
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01151200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2921308Medicaid