Provider Demographics
NPI:1891810032
Name:SCHLEBACH, KATHLEEN MARION (RDH BS)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARION
Last Name:SCHLEBACH
Suffix:
Gender:F
Credentials:RDH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3541 W WALNUT HILL LANE
Mailing Address - Street 2:# 2036
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038
Mailing Address - Country:US
Mailing Address - Phone:214-674-8399
Mailing Address - Fax:972-618-9369
Practice Address - Street 1:6841 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5417
Practice Address - Country:US
Practice Address - Phone:972-618-5000
Practice Address - Fax:972-618-9369
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13722124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist