Provider Demographics
NPI:1699093484
Name:SCHREINER, KAYLA M (DDS)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:M
Last Name:SCHREINER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MONROE ST STE B
Mailing Address - Street 2:
Mailing Address - City:MONDOVI
Mailing Address - State:WI
Mailing Address - Zip Code:54755-1731
Mailing Address - Country:US
Mailing Address - Phone:715-926-4237
Mailing Address - Fax:
Practice Address - Street 1:132 MONROE ST STE B
Practice Address - Street 2:
Practice Address - City:MONDOVI
Practice Address - State:WI
Practice Address - Zip Code:54755-1731
Practice Address - Country:US
Practice Address - Phone:715-926-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI390200000X
WI6523-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program