Provider Demographics
NPI:1710159587
Name:CHARLES W. SCHMIDT
Entity Type:Organization
Organization Name:CHARLES W. SCHMIDT
Other - Org Name:GENTLE DENTAL INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORCHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-365-1717
Mailing Address - Street 1:9800 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-4802
Mailing Address - Country:US
Mailing Address - Phone:813-988-9276
Mailing Address - Fax:813-985-6449
Practice Address - Street 1:9800 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-4802
Practice Address - Country:US
Practice Address - Phone:813-988-9276
Practice Address - Fax:813-985-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty