MEDICARE: RONALD D SCHOWENGERDT 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

General Provider Information

NPI Number	:	1881216844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD D SCHOWENGERDT DDS

Provider Business Mailing Address
First Line	:	1701 W AUSTIN BLVD
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-3720
Country	:	US
Telephone Number	:	417-667-7134
Fax Number	:	417-667-4127

Provider Business Practice Location Address
First Line	:	1701 W AUSTIN BLVD
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-3720
Country	:	US
Telephone Number	:	417-667-7134
Fax Number	:	417-667-4127

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RONALD D SCHOWENGERDT
Credential	:	DDS
Telephone Number	:	417-667-7134

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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