Provider Demographics
NPI:1083690424
Name:SCHNEIDER, ROBERT L (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51300 POMERANTZ FAMILY PAVILION
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-356-2743
Mailing Address - Fax:319-353-6923
Practice Address - Street 1:51300 POMERANTZ FAMILY PAVILION
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-2743
Practice Address - Fax:319-353-6923
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA072771223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0458935Medicaid
T01268Medicare UPIN
IAI14708Medicare ID - Type Unspecified