Provider Demographics
NPI:1881066025
Name:SCHMOTTER, RICHARD ALEX (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALEX
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 1:66 CLEARY CT
Mailing Address - Street 2:#605
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6559
Mailing Address - Country:US
Mailing Address - Phone:415-302-0532
Mailing Address - Fax:
Practice Address - Street 1:66 CLEARY CT
Practice Address - Street 2:#605
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6559
Practice Address - Country:US
Practice Address - Phone:415-302-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist