Provider Demographics
NPI:1841451697
Name:SCHNEIDER, KEITH M (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6425
Mailing Address - Country:US
Mailing Address - Phone:440-771-7070
Mailing Address - Fax:
Practice Address - Street 1:7207 HOPKINS RD
Practice Address - Street 2:ORAL AND MAXILLOFACIAL SURGERY
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6425
Practice Address - Country:US
Practice Address - Phone:440-255-3700
Practice Address - Fax:440-255-4375
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0228921223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery