Provider Demographics
NPI:1386021020
Name:ROBERT L SCHMIDT DMD PLLC
Entity Type:Organization
Organization Name:ROBERT L SCHMIDT DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-873-1968
Mailing Address - Street 1:1706 DAVIE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-3589
Mailing Address - Country:US
Mailing Address - Phone:704-873-1968
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9379261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental