Provider Demographics
NPI:1467620831
Name:SCHROYER, GARY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:SCHROYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N RIVERSIDE
Mailing Address - Street 2:SUITE E2A
Mailing Address - City:ST CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079
Mailing Address - Country:US
Mailing Address - Phone:810-329-2289
Mailing Address - Fax:810-329-6387
Practice Address - Street 1:201 N RIVERSIDE
Practice Address - Street 2:SUITE E2A
Practice Address - City:ST CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079
Practice Address - Country:US
Practice Address - Phone:810-329-2289
Practice Address - Fax:810-329-6387
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI105711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice