Provider Demographics
NPI:1255453015
Name:SCHROEDER, STEPHEN LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LYNN
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:GREEN VALLEY CENTER
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770-9030
Mailing Address - Country:US
Mailing Address - Phone:301-865-5333
Mailing Address - Fax:301-865-5336
Practice Address - Street 1:11801 FINGERBOARD RD
Practice Address - Street 2:SUITE #14 LOWER LEVEL
Practice Address - City:MONROVIA
Practice Address - State:MD
Practice Address - Zip Code:21770-9030
Practice Address - Country:US
Practice Address - Phone:301-865-5333
Practice Address - Fax:301-865-5336
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD60021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice