Individual
KELLY AMANDA SCHNEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(920) 973-8885
Mailing address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001492-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2024
Last updated
10/02/2025
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