Provider Demographics
NPI:1104178169
Name:SCHMIDT, ROBERT LOGAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LOGAN
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 CLUB TROPHY LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6884
Mailing Address - Country:US
Mailing Address - Phone:704-607-0348
Mailing Address - Fax:
Practice Address - Street 1:1706 DAVIE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3589
Practice Address - Country:US
Practice Address - Phone:704-873-1968
Practice Address - Fax:704-872-5841
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9379122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist