Provider Demographics
NPI:1871799841
Name:STEPHEN R. GSCHREY, DMD
Entity type:Organization
Organization Name:STEPHEN R. GSCHREY, DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:GSCHREY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-691-3050
Mailing Address - Street 1:2551 BAGLYOS CIRCLE
Mailing Address - Street 2:SUITE A-12
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8042
Mailing Address - Country:US
Mailing Address - Phone:610-691-3050
Mailing Address - Fax:610-691-7950
Practice Address - Street 1:2551 BAGLYOS CIRCLE
Practice Address - Street 2:SUITE A-12
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8042
Practice Address - Country:US
Practice Address - Phone:610-691-3050
Practice Address - Fax:610-691-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADX0017411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADX001741OtherSTATE LICENSE