Provider Demographics
NPI:1467653493
Name:SCHRAGER DENTAL CORPORATION
Entity Type:Organization
Organization Name:SCHRAGER DENTAL CORPORATION
Other - Org Name:MADISON SPRINGS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICU
Authorized Official - Middle Name:SORIN
Authorized Official - Last Name:SCHRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-698-3585
Mailing Address - Street 1:25285 MADISON AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8955
Mailing Address - Country:US
Mailing Address - Phone:951-698-3585
Mailing Address - Fax:951-698-3581
Practice Address - Street 1:25285 MADISON AVE STE 107
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8955
Practice Address - Country:US
Practice Address - Phone:951-698-3585
Practice Address - Fax:951-698-3581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty