Provider Demographics
NPI:1972589216
Name:SCHMELTZER, LAWRENCE DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:DAVID
Last Name:SCHMELTZER
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 1:149 HART ST STE 4
Mailing Address - Street 2:82 DENTAL SQUADRON SGD
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-3481
Mailing Address - Country:US
Mailing Address - Phone:940-676-4474
Mailing Address - Fax:940-676-3502
Practice Address - Street 1:149 HART ST STE 4
Practice Address - Street 2:82 DENTAL SQUADRON SGD
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3481
Practice Address - Country:US
Practice Address - Phone:940-676-4474
Practice Address - Fax:940-676-5903
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice