Provider Demographics
NPI:1235268244
Name:SCHMIDT, JOSEPH GUSTAVA JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GUSTAVA
Last Name:SCHMIDT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6705 W HIGHWAY 290
Mailing Address - Street 2:SUITE 504
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8400
Mailing Address - Country:US
Mailing Address - Phone:512-892-5335
Mailing Address - Fax:512-892-5384
Practice Address - Street 1:6705 W HIGHWAY 290
Practice Address - Street 2:SUITE 504
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8400
Practice Address - Country:US
Practice Address - Phone:512-892-5335
Practice Address - Fax:512-892-5384
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX133991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice