Provider Demographics
NPI:1922137652
Name:DR EDWARD A SCHANDA AND DR ALBERT H SCHANDA DDS LLC
Entity Type:Organization
Organization Name:DR EDWARD A SCHANDA AND DR ALBERT H SCHANDA DDS LLC
Other - Org Name:PARTNERSHIP
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-546-2151
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MO
Mailing Address - Zip Code:65653
Mailing Address - Country:US
Mailing Address - Phone:417-546-2151
Mailing Address - Fax:417-546-6866
Practice Address - Street 1:16040 US HWY 160
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MO
Practice Address - Zip Code:65653
Practice Address - Country:US
Practice Address - Phone:417-546-2151
Practice Address - Fax:417-546-6866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO179047491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty