MEDICARE: ROBERT R SCHROEDER DENTIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	500-1376	WI

General Provider Information

NPI Number	:	1679571509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT R SCHROEDER DENTIST

Provider Business Mailing Address
First Line	:	122 N MAIN ST
Second Line	:
City	:	CUBA CITY
State	:	WI
Zip	:	53807-1538
Country	:	US
Telephone Number	:	608-744-2111
Fax Number	:	608-744-2112

Provider Business Practice Location Address
First Line	:	122 N MAIN ST
Second Line	:
City	:	CUBA CITY
State	:	WI
Zip	:	53807-1538
Country	:	US
Telephone Number	:	608-744-2111
Fax Number	:	608-744-2112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/08/2007

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Directions to “ ROBERT R SCHROEDER DENTIST” Practice Location

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