MEDICARE: DR. LAURA SCHNAIDT D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2675	AZ

General Provider Information

NPI Number	:	1356519862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA SCHNAIDT D.M.D.

Provider Business Mailing Address
First Line	:	26232 N. TATUM BLVD STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-7502
Country	:	US
Telephone Number	:	480-513-1097
Fax Number	:	480-513-1365

Provider Business Practice Location Address
First Line	:	26232 N TATUM BLVD STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-7502
Country	:	US
Telephone Number	:	480-513-1097
Fax Number	:	480-513-1365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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