Provider Demographics
NPI:1770623415
Name:SCHNEIDER, LANCE P (DDS)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:P
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 1:1300 N MCCLINTOCK DR
Mailing Address - Street 2:STE B2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-7205
Mailing Address - Country:US
Mailing Address - Phone:480-777-9938
Mailing Address - Fax:480-491-0132
Practice Address - Street 1:1300 N MCCLINTOCK DR
Practice Address - Street 2:STE B2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-7205
Practice Address - Country:US
Practice Address - Phone:480-777-9938
Practice Address - Fax:480-491-0132
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics