Healthcare Provider Details

I. General information

NPI: 1154338853
Provider Name (Legal Business Name): ROBERT A SCHOETTGER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 S 13TH ST
LINCOLN NE
68512-9371
US

IV. Provider business mailing address

8000 S 13TH ST
LINCOLN NE
68512-9371
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-8000
  • Fax: 402-423-8002
Mailing address:
  • Phone: 402-423-8000
  • Fax: 402-423-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4938
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: