Provider Demographics
NPI:1003827932
Name:DRS. CRAINE, SCHANTZ & MORANDA
Entity Type:Organization
Organization Name:DRS. CRAINE, SCHANTZ & MORANDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, M DENT SC
Authorized Official - Phone:760-568-5987
Mailing Address - Street 1:73211 FRED WARING DR STE 201
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2871
Mailing Address - Country:US
Mailing Address - Phone:760-568-5987
Mailing Address - Fax:760-776-1826
Practice Address - Street 1:73211 FRED WARING DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2871
Practice Address - Country:US
Practice Address - Phone:760-568-5987
Practice Address - Fax:760-776-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty