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General NPI Number Information
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NPI Number | 1669213674
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Entity Type | Individual
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Provider Name | PARIS NICOLE SCHROEDER
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 217 W 6TH ST
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City | STORM LAKE
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State | IA
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Zip | 50588-1819
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Country | US
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Telephone | 712-732-2319
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Fax |
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Provider Business Mailing Address
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Address Line | 4319 490TH ST
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City | GRANVILLE
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State | IA
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Zip | 51022-8005
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Country | US
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Telephone | 712-540-2519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS-10215
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License Number State | IA
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