Provider Demographics
NPI:1235454794
Name:JODY SCHILLING DDS SC
Entity type:Organization
Organization Name:JODY SCHILLING DDS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-216-7250
Mailing Address - Street 1:2501 W BELTLINE HWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2318
Mailing Address - Country:US
Mailing Address - Phone:608-216-7250
Mailing Address - Fax:608-216-7251
Practice Address - Street 1:2501 W BELTLINE HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2318
Practice Address - Country:US
Practice Address - Phone:608-216-7250
Practice Address - Fax:608-216-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6422-015261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental