Provider Demographics
NPI:1982808853
Name:SCHMITZ, STACY M (DDS)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:M
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 OLD SEWARD HWY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2276
Mailing Address - Country:US
Mailing Address - Phone:907-522-3633
Mailing Address - Fax:
Practice Address - Street 1:6917 OLD SEWARD HWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2276
Practice Address - Country:US
Practice Address - Phone:907-522-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6688122300000X
AK1259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist