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General NPI Number Information
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NPI Number | 1336522432
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Entity Type | Organization
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Legal Business Name | LAKEVIEW ORTHODONTICS PC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 1939 PATTERSON ST STE 103
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-2017
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Country | US
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Telephone | 256-582-3398
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Fax | 256-582-8430
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Provider Business Mailing Address
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Address Line | 1939 PATTERSON ST STE 103
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-2017
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Country | US
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Telephone | 256-582-3398
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Fax | 256-582-8430
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DON W SCHMIDTKE
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Credential | DMD, MS
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Telephone | 256-582-3398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5595
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License Number State | AL
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