Provider Demographics
NPI:1043332448
Name:SCHRIEFER, MARK ALFRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALFRED
Last Name:SCHRIEFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5636 SPRING VALLEY RD
Mailing Address - Street 2:#25D
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-3170
Mailing Address - Country:US
Mailing Address - Phone:972-980-1669
Mailing Address - Fax:972-702-0662
Practice Address - Street 1:1243 E RED BIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-2008
Practice Address - Country:US
Practice Address - Phone:214-372-6062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice