Provider Demographics
NPI:1871735746
Name:KARL E SCHNECK DDS PC
Entity type:Organization
Organization Name:KARL E SCHNECK DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-779-4344
Mailing Address - Street 1:1094 ROYAL CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6138
Mailing Address - Country:US
Mailing Address - Phone:541-779-4344
Mailing Address - Fax:541-776-9849
Practice Address - Street 1:1094 ROYAL CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6138
Practice Address - Country:US
Practice Address - Phone:541-779-4344
Practice Address - Fax:541-776-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD92391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty