Lynn Marie Schmader, DDS
Individual provider Active NPI Dentist · Bourbon, MO
NPI 1124285309 · NPPES record last updated May 16, 2008
Key facts
- NPI
- 1124285309
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 015332 (MO)
- Practice address
- 246 College
Bourbon, MO 65441-0129 - Phone
- (573) 732-5505
- NPI assigned
- May 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015332 | MO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 015332 | MO | Yes |
Addresses
Primary practice location
246 College
Bourbon, MO 65441-0129
Mailing address
PO Box 129
Bourbon, MO 65441-0129
Phone (573) 732-5505
Other providers in Bourbon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.