Provider Demographics
NPI:1689889586
Name:SCHMIDT, JOHN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3871 ELIZABETHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-8360
Mailing Address - Country:US
Mailing Address - Phone:717-618-1682
Mailing Address - Fax:
Practice Address - Street 1:1755 OREGON PIKE
Practice Address - Street 2:SUITE #102
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4272
Practice Address - Country:US
Practice Address - Phone:717-569-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030276L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice