Provider Demographics
NPI:1528575594
Name:SCHNEIDER, D.D.S.& KYE, D.D.S., PA
Entity Type:Organization
Organization Name:SCHNEIDER, D.D.S.& KYE, D.D.S., PA
Other - Org Name:CAROLINA DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KYE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-759-8210
Mailing Address - Street 1:9336 BLAKENEY CENTRE DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6667
Mailing Address - Country:US
Mailing Address - Phone:704-759-8210
Mailing Address - Fax:
Practice Address - Street 1:9336 BLAKENEY CENTER DRIVE
Practice Address - Street 2:SUITE 100-A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2827
Practice Address - Country:US
Practice Address - Phone:704-759-8210
Practice Address - Fax:704-759-8210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6149261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental