Provider Demographics
NPI:1023574753
Name:SANTA MARIA & SCHNEIDER D.M.D WATERBURY LLC
Entity Type:Organization
Organization Name:SANTA MARIA & SCHNEIDER D.M.D WATERBURY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SANTA MARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-767-2416
Mailing Address - Street 1:276 HIGHLAND AVE.
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-575-9798
Mailing Address - Fax:203-575-1286
Practice Address - Street 1:276 HIGHLAND AVE.
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-575-9798
Practice Address - Fax:203-575-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty