Provider Demographics
NPI:1639179245
Name:SCHUSTER, FREDERICA ANN HOFF (DDS)
Entity Type:Individual
Prefix:
First Name:FREDERICA
Middle Name:ANN HOFF
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:FREDERICA
Other - Middle Name:HOFF
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1209 SHOREWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2265
Mailing Address - Country:US
Mailing Address - Phone:608-217-6964
Mailing Address - Fax:
Practice Address - Street 1:1100 E VERONA AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-8717
Practice Address - Country:US
Practice Address - Phone:608-845-6601
Practice Address - Fax:608-845-1264
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4411-0151223G0001X
WI44111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice