Provider Demographics
NPI:1376939868
Name:BRADLEY SCHNEBEL, DMD, PLLC
Entity Type:Organization
Organization Name:BRADLEY SCHNEBEL, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-732-3777
Mailing Address - Street 1:450 MAMARONECK AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 MAMARONECK AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2400
Practice Address - Country:US
Practice Address - Phone:914-732-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0555931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty