Provider Demographics
NPI:1407143258
Name:SCHMITT, PHILIP LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LOUIS
Last Name:SCHMITT
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 1:300 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4031
Mailing Address - Country:US
Mailing Address - Phone:563-243-2324
Mailing Address - Fax:563-242-0402
Practice Address - Street 1:300 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4031
Practice Address - Country:US
Practice Address - Phone:563-243-2324
Practice Address - Fax:563-242-0402
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist