Provider Demographics
NPI:1831323021
Name:SCHMIDT, CRYSTAL DANIELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:DANIELLE
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 1:1110 COLLEGE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1207
Mailing Address - Country:US
Mailing Address - Phone:701-712-0770
Mailing Address - Fax:
Practice Address - Street 1:1110 COLLEGE DR STE 110
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1207
Practice Address - Country:US
Practice Address - Phone:701-712-0770
Practice Address - Fax:701-975-3050
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND20491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice