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General NPI Number Information
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NPI Number | 1578853933
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Entity Type | Organization
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Legal Business Name | RYAN SCHROEDER DDS PC
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 210 S MAIN ST
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City | YALE
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State | MI
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Zip | 48097-3319
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Country | US
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Telephone | 810-387-4746
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Fax |
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Provider Business Mailing Address
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Address Line | 611 E WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53202-4695
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | TRUST OFFICER
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Name | LAURA WINKEL
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Credential |
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Telephone | 414-665-5211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2901010920
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License Number State | MI
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