Provider Demographics
NPI:1992825657
Name:SCHROER, MICHAEL (DDS,PLC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SCHROER
Suffix:
Gender:M
Credentials:DDS,PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PACKETS CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5629
Mailing Address - Country:US
Mailing Address - Phone:757-221-0249
Mailing Address - Fax:
Practice Address - Street 1:200 PACKETS CT
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5629
Practice Address - Country:US
Practice Address - Phone:757-221-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014111751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics