Provider Demographics
NPI:1881722288
Name:SCHRODY, DAVID WILLIAM (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:SCHRODY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 LINCOLN WAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7203
Mailing Address - Country:US
Mailing Address - Phone:563-242-2999
Mailing Address - Fax:563-242-2980
Practice Address - Street 1:2635 LINCOLN WAY
Practice Address - Street 2:SUITE E
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7203
Practice Address - Country:US
Practice Address - Phone:563-242-2999
Practice Address - Fax:563-242-2980
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA054681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1072181Medicaid