Provider Demographics
NPI:1649395344
Name:WILLIAM F. SCHROEDER D.D.S.,P.C.
Entity Type:Organization
Organization Name:WILLIAM F. SCHROEDER D.D.S.,P.C.
Other - Org Name:PAUL A. SHEPHERD D.M.D.,M.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:770-474-0007
Mailing Address - Street 1:125 EAGLES POINTE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6379
Mailing Address - Country:US
Mailing Address - Phone:770-474-0007
Mailing Address - Fax:770-474-5453
Practice Address - Street 1:125 EAGLES POINTE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6379
Practice Address - Country:US
Practice Address - Phone:770-474-0007
Practice Address - Fax:770-474-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127121223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty