Healthcare Provider Details

I. General information

NPI: 1982009544
Provider Name (Legal Business Name): TODD SCHROEDER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 NE 5TH AVE
MILTON FREEWATER OR
97862-1701
US

IV. Provider business mailing address

13 NE 5TH AVE
MILTON FREEWATER OR
97862-1701
US

V. Phone/Fax

Practice location:
  • Phone: 541-938-0400
  • Fax:
Mailing address:
  • Phone: 541-938-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. TODD SCHROEDER
Title or Position: PRESIDENT/OWNER
Credential: DDS
Phone: 541-938-0400