MEDICARE: TIMOTHY M. 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	105018	CO

General Provider Information

NPI Number	:	1740657378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY M. SCHROEDER DDS

Provider Business Mailing Address
First Line	:	6565 W JEWELL AVE STE 3
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7102
Country	:	US
Telephone Number	:	303-937-6345
Fax Number	:	303-937-6331

Provider Business Practice Location Address
First Line	:	6565 W JEWELL AVE STE 3
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7102
Country	:	US
Telephone Number	:	303-937-6345
Fax Number	:	303-937-6331

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CATHY BELL
Credential	:
Telephone Number	:	303-937-6345

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/31/2015

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