MEDICARE: DR. M. LAWRENCE SCHROEDER DDS

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	1223G0001X	General Practice Dentistry	MN 8403	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326039942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. M. LAWRENCE SCHROEDER DDS

Provider Business Mailing Address
First Line	:	2830 AUTUMN WOODS DR
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-1145
Country	:	US
Telephone Number	:	952-448-4116
Fax Number	:

Provider Business Practice Location Address
First Line	:	5129 W 98TH ST
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55437-2040
Country	:	US
Telephone Number	:	952-835-5082
Fax Number	:

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/09/2007

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