Provider Demographics
NPI:1942739776
Name:SCHROEDER, SETH THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:THOMAS
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 1:225 N CLIFF AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-2524
Mailing Address - Country:US
Mailing Address - Phone:605-213-1230
Mailing Address - Fax:
Practice Address - Street 1:225 N CLIFF AVE STE 2
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032-2524
Practice Address - Country:US
Practice Address - Phone:605-213-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-094251223G0001X
SDD12261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice