Schrader, Jack Lee

Schrader, Jack Lee is an individual health care provider with primary practice located at 1900 Paseo San Luis , Sierra Vista AZ 85635-4614. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Schrader, Jack Lee can be contacted via phone (520) 458-2415.

Contact Information

Primary practice address
1900 Paseo San Luis Sierra Vista AZ 85635-4614
Phone: (520) 458-2415
Fax: (520) 458-0414
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X AZ2165 Arizona

Profile Details

NPI number 1457313579
LBN Legal business name Schrader, Jack Lee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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