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General NPI Number Information
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NPI Number | 1528767373
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Entity Type | Organization
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Legal Business Name | DAVID E. SCHMIDT, D.D.S., P.C.
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 825 S WAUKEGAN RD STE A1
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City | LAKE FOREST
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State | IL
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Zip | 60045-2665
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Country | US
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Telephone | 847-234-4800
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Fax | 847-234-4876
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Provider Business Mailing Address
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Address Line | 825 S WAUKEGAN RD STE A1
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City | LAKE FOREST
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State | IL
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Zip | 60045-2665
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Country | US
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Telephone | 847-234-4800
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Fax | 847-234-4876
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. DAVID ERIC SCHMIDT
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Credential | DDS
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Telephone | 847-234-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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