Provider Demographics
NPI:1760527733
Name:SCHROEDER, KATRINA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:M
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S PARK AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4269
Mailing Address - Country:US
Mailing Address - Phone:407-886-1611
Mailing Address - Fax:407-886-2117
Practice Address - Street 1:20 S PARK AVE
Practice Address - Street 2:SUITE A
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4269
Practice Address - Country:US
Practice Address - Phone:407-886-1611
Practice Address - Fax:407-886-2117
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN176981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice