Provider Demographics
NPI:1477237170
Name:SCHMALZ, ANDREAS CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:CHRISTOPHER
Last Name:SCHMALZ
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 1:1748 E SOUTHRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-3925
Mailing Address - Country:US
Mailing Address - Phone:970-209-6701
Mailing Address - Fax:
Practice Address - Street 1:1120 N ROCK RD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-3584
Practice Address - Country:US
Practice Address - Phone:316-789-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice