Provider Demographics
NPI:1689685414
Name:SCHNEIDER, ROBERT HENRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HENRY
Last Name:SCHNEIDER
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 1:4692 E UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6155
Mailing Address - Country:US
Mailing Address - Phone:432-550-3220
Mailing Address - Fax:432-367-7426
Practice Address - Street 1:4692 E UNIVERSITY BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-6155
Practice Address - Country:US
Practice Address - Phone:432-550-3220
Practice Address - Fax:432-367-7426
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice