Provider Demographics
NPI:1154338853
Name:SCHOETTGER, ROBERT A (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:SCHOETTGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-9371
Mailing Address - Country:US
Mailing Address - Phone:402-423-8000
Mailing Address - Fax:402-423-8002
Practice Address - Street 1:8000 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9371
Practice Address - Country:US
Practice Address - Phone:402-423-8000
Practice Address - Fax:402-423-8002
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE49381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47054472901Medicaid