Provider Demographics
NPI:1205573417
Name:SCHNEIDER DENTAL
Entity type:Organization
Organization Name:SCHNEIDER DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-577-1614
Mailing Address - Street 1:7516 N CAMINO SIN VACAS
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1251
Mailing Address - Country:US
Mailing Address - Phone:480-577-1614
Mailing Address - Fax:
Practice Address - Street 1:4820 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1276
Practice Address - Country:US
Practice Address - Phone:480-577-1614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty