MEDICARE: RICHARD ALEX SCHMOTTER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	65072	CA

General Provider Information

NPI Number	:	1881066025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ALEX SCHMOTTER DDS

Provider Business Mailing Address
First Line	:	66 CLEARY CT
Second Line	:	#605
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6559
Country	:	US
Telephone Number	:	415-302-0532
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 CLEARY CT
Second Line	:	#605
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6559
Country	:	US
Telephone Number	:	415-302-0532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	10/27/2015

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