Provider Demographics
NPI:1760657670
Name:DR. CHRISTOPHER E. SCHMIDTKE, DDS
Entity Type:Organization
Organization Name:DR. CHRISTOPHER E. SCHMIDTKE, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SCHMIDTKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-892-0814
Mailing Address - Street 1:17036 KENTON DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5772
Mailing Address - Country:US
Mailing Address - Phone:704-892-0814
Mailing Address - Fax:704-892-0817
Practice Address - Street 1:17036 KENTON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5772
Practice Address - Country:US
Practice Address - Phone:704-892-0814
Practice Address - Fax:704-892-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty