Provider Demographics
NPI:1588777619
Name:SCHNEIDER, DAVID MARTIN (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARTIN
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CENTER
Mailing Address - Street 2:SUITE #128Q
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-232-9003
Mailing Address - Fax:978-232-9034
Practice Address - Street 1:100 CUMMINGS CENTER
Practice Address - Street 2:SUITE #128Q
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-232-9003
Practice Address - Fax:978-232-9034
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA103491223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics