Provider Demographics
NPI:1932546660
Name:SCHMALTZ, CHRISTOPHER J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:SCHMALTZ
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 1:4877 28TH AVE S
Mailing Address - Street 2:APT 207
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8457
Mailing Address - Country:US
Mailing Address - Phone:701-799-4898
Mailing Address - Fax:
Practice Address - Street 1:1220 MAIN AVE
Practice Address - Street 2:SUITE #220
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8201
Practice Address - Country:US
Practice Address - Phone:701-237-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND21621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice