Provider Demographics
NPI:1750462024
Name:SCHNEIDER-UTZ, MABEL BEATRIZ (DDS)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:BEATRIZ
Last Name:SCHNEIDER-UTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 N HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-2847
Mailing Address - Country:US
Mailing Address - Phone:626-333-8166
Mailing Address - Fax:626-333-9879
Practice Address - Street 1:864 N HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-2847
Practice Address - Country:US
Practice Address - Phone:626-333-8166
Practice Address - Fax:626-333-9879
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA379131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice