Provider Demographics
NPI:1467475004
Name:SCHMIDT, JOANNE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:S
Last Name:SCHMIDT
Suffix:
Gender:F
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:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:RIEGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18077-0004
Mailing Address - Country:US
Mailing Address - Phone:610-749-2717
Mailing Address - Fax:610-749-0782
Practice Address - Street 1:1235 EATON RD.
Practice Address - Street 2:
Practice Address - City:RIEGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18077-0004
Practice Address - Country:US
Practice Address - Phone:610-749-2717
Practice Address - Fax:610-749-0782
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019848L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist