Provider Demographics
NPI:1568803278
Name:SCHRAEDER, PRESTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:
Last Name:SCHRAEDER
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 1:522 WEEPING WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2545
Mailing Address - Country:US
Mailing Address - Phone:785-760-0585
Mailing Address - Fax:
Practice Address - Street 1:5129 N GARLAND AVE STE 700
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2746
Practice Address - Country:US
Practice Address - Phone:972-276-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00204593122300000X
TX29114122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist