Basic Information
| Provider Information | |||||||||
| NPI: | 1679905434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHAAR | ||||||||
| FirstName: | AUSTIN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | CMR 427 BOX 2645 | ||||||||
| Address2: | APO AE | ||||||||
| City: | VICENZA | ||||||||
| State: | VENETO | ||||||||
| PostalCode: | 09630 | ||||||||
| CountryCode: | IT | ||||||||
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| Practice Location | |||||||||
| Address1: | BUILDING 9900, 2ND FLOOR | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539684035 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2013 | ||||||||
| LastUpdateDate: | 06/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 2901021041 | MI | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | D10793 | 01 | OR | MILITARY | OTHER | 2901021041 | 01 | MI | MILITARY | OTHER |