Provider Demographics
NPI:1629189923
Name:SCHNEIDER, GREGG SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:SCOTT
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 1:1271 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-1919
Mailing Address - Country:US
Mailing Address - Phone:908-925-0088
Mailing Address - Fax:908-374-5435
Practice Address - Street 1:1271 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-1919
Practice Address - Country:US
Practice Address - Phone:908-925-0088
Practice Address - Fax:908-374-5435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ164551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice