Provider Demographics
NPI:1104828656
Name:SCHREINER, CARL S III (DDS INC)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:S
Last Name:SCHREINER
Suffix:III
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1641
Mailing Address - Country:US
Mailing Address - Phone:580-255-4880
Mailing Address - Fax:580-475-0386
Practice Address - Street 1:2035 W ELK AVE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1641
Practice Address - Country:US
Practice Address - Phone:580-255-4880
Practice Address - Fax:580-475-0386
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice