Basic Information
| Provider Information | |||||||||
| NPI: | 1003813858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHOEN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1016 | ||||||||
| Address2: | |||||||||
| City: | HAPPY CAMP | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960391016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304931600 | ||||||||
| FaxNumber: | 5304931648 | ||||||||
| Practice Location | |||||||||
| Address1: | 1519 S OREGON ST | ||||||||
| Address2: | |||||||||
| City: | YREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960973425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308429200 | ||||||||
| FaxNumber: | 5308429217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 02/23/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 23032 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.