Provider Demographics
NPI:1306469093
Name:KS DENTAL
Entity type:Organization
Organization Name:KS 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:RITA
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-577-1614
Mailing Address - Street 1:3275 W INA RD
Mailing Address - Street 2:#101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741
Mailing Address - Country:US
Mailing Address - Phone:520-888-2900
Mailing Address - Fax:520-408-1854
Practice Address - Street 1:3275 W INA RD
Practice Address - Street 2:#101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-888-2900
Practice Address - Fax:520-408-1854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty