Provider Demographics
NPI:1124367206
Name:SCHNEIDER FAMILY DENTISTRY INC
Entity Type:Organization
Organization Name:SCHNEIDER FAMILY DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:316-687-0777
Mailing Address - Street 1:9360 E CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2560
Mailing Address - Country:US
Mailing Address - Phone:316-687-0777
Mailing Address - Fax:316-636-5885
Practice Address - Street 1:9360 E CENTRAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2560
Practice Address - Country:US
Practice Address - Phone:316-687-0777
Practice Address - Fax:316-636-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty