Provider Demographics
NPI:1851405690
Name:SCHROEDER, JEFFREY V (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:V
Last Name:SCHROEDER
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 1:3733 W NEPTUNE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5118
Mailing Address - Country:US
Mailing Address - Phone:813-254-1007
Mailing Address - Fax:
Practice Address - Street 1:3733 W NEPTUNE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5118
Practice Address - Country:US
Practice Address - Phone:813-254-1007
Practice Address - Fax:813-254-1177
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN93111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice