Healthcare Provider Details

I. General information

NPI: 1336311083
Provider Name (Legal Business Name): LAURET SCHREIER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13915 N DYSART RD A-1
EL MIRAGE AZ
85335-7335
US

IV. Provider business mailing address

13915 N DYSART RD A-1
EL MIRAGE AZ
85335-7335
US

V. Phone/Fax

Practice location:
  • Phone: 623-444-6340
  • Fax: 623-444-6350
Mailing address:
  • Phone: 623-444-6340
  • Fax: 623-444-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5287
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: