Provider Demographics
NPI:1912100892
Name:SCHOENBRODT, FREDERICK ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ARTHUR
Last Name:SCHOENBRODT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9005 CHEVROLET DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-465-5253
Mailing Address - Fax:410-418-5830
Practice Address - Street 1:9005 CHEVROLET DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-465-5253
Practice Address - Fax:410-418-5830
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD46481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics