Provider Demographics
NPI:1770128977
Name:SCHMITT DENTAL PC
Entity type:Organization
Organization Name:SCHMITT DENTAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OFI INTEGRATON
Authorized Official - Prefix:
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOESTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:549-675-3088
Mailing Address - Street 1:1692 FORT CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7531
Mailing Address - Country:US
Mailing Address - Phone:931-552-7745
Mailing Address - Fax:931-645-3545
Practice Address - Street 1:1692 FORT CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-7531
Practice Address - Country:US
Practice Address - Phone:931-552-7745
Practice Address - Fax:931-645-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty