Provider Demographics
NPI:1023148251
Name:SCHMOTTER, RICHARD EARL (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EARL
Last Name:SCHMOTTER
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 1:770 TAMALPAIS DR
Mailing Address - Street 2:#304
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1700
Mailing Address - Country:US
Mailing Address - Phone:415-927-4000
Mailing Address - Fax:415-927-7686
Practice Address - Street 1:770 TAMALPAIS DR
Practice Address - Street 2:304
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1700
Practice Address - Country:US
Practice Address - Phone:415-927-4000
Practice Address - Fax:415-927-7686
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADK032175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADK032175OtherDENTAL LICENSE