Provider Demographics
NPI:1346378551
Name:GERALD C SCHMITZ DMD
Entity Type:Organization
Organization Name:GERALD C SCHMITZ DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-464-2002
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-8026
Mailing Address - Country:US
Mailing Address - Phone:636-464-2002
Mailing Address - Fax:636-464-2003
Practice Address - Street 1:1500 PREHISTORIC HILL DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-2288
Practice Address - Country:US
Practice Address - Phone:636-464-2002
Practice Address - Fax:636-464-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty