Provider Demographics
NPI:1205030442
Name:SCHNEIDER, GENE B (DDS)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:B
Last Name:SCHNEIDER
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 1:1245 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-2579
Mailing Address - Country:US
Mailing Address - Phone:605-347-2509
Mailing Address - Fax:605-347-2500
Practice Address - Street 1:1245 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-2579
Practice Address - Country:US
Practice Address - Phone:605-347-2509
Practice Address - Fax:605-347-2500
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist