Provider Demographics
NPI:1356632368
Name:SCHROEDER, DANIEL BRETTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRETTON
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 PEACHTREE DUNWOODY RD STE 225
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5696
Mailing Address - Country:US
Mailing Address - Phone:770-522-0099
Mailing Address - Fax:
Practice Address - Street 1:6115 PEACHTREE DUNWOODY RD STE 225
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5696
Practice Address - Country:US
Practice Address - Phone:770-522-0099
Practice Address - Fax:770-522-0094
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
GADN0144321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program