Healthcare Provider Details

I. General information

NPI: 1861687840
Provider Name (Legal Business Name): S. CRAIG SCHNEIDER D.D.S., M.A.G.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8885 CENTRE PARK DR STE 2E
COLUMBIA MD
21045-2199
US

IV. Provider business mailing address

3024 SENECA CHIEF TRL
ELLICOTT CITY MD
21042-1418
US

V. Phone/Fax

Practice location:
  • Phone: 410-715-8951
  • Fax: 410-715-8949
Mailing address:
  • Phone: 410-591-5217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number8483
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: