Provider Demographics
NPI:1184060279
Name:SCHROEDER DENTAL, INC.
Entity type:Organization
Organization Name:SCHROEDER DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-923-8878
Mailing Address - Street 1:4781 PAOLI PIKE STE 3
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9629
Mailing Address - Country:US
Mailing Address - Phone:812-923-8878
Mailing Address - Fax:812-923-8876
Practice Address - Street 1:4781 PAOLI PIKE STE 3
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9629
Practice Address - Country:US
Practice Address - Phone:812-923-8878
Practice Address - Fax:812-923-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011856A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty