Provider Demographics
NPI:1124285309
Name:SCHMADER, LYNN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:MARIE
Last Name:SCHMADER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:BOURBON
Mailing Address - State:MO
Mailing Address - Zip Code:65441-0129
Mailing Address - Country:US
Mailing Address - Phone:573-732-5505
Mailing Address - Fax:
Practice Address - Street 1:246 COLLEGE
Practice Address - Street 2:
Practice Address - City:BOURBON
Practice Address - State:MO
Practice Address - Zip Code:65441-0129
Practice Address - Country:US
Practice Address - Phone:573-732-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO015332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist