Provider Demographics
NPI:1952524456
Name:CHARLES W. SCHMIDT DDS PA
Entity Type:Organization
Organization Name:CHARLES W. SCHMIDT DDS PA
Other - Org Name:GENTLE DENTAL INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:941-365-1717
Mailing Address - Street 1:2090 FLAMINGO DR
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-4262
Mailing Address - Country:US
Mailing Address - Phone:863-533-0383
Mailing Address - Fax:863-533-7293
Practice Address - Street 1:2090 FLAMINGO DR
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4262
Practice Address - Country:US
Practice Address - Phone:863-533-0383
Practice Address - Fax:863-533-7293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty