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General NPI Number Information
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NPI Number | 1861640591
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Entity Type | Organization
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Legal Business Name | STEVEN A. SCHMIDT, D.D.S., S.C.
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Dates
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Enumeration Date | 09/06/2008
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Last Update Date | 09/06/2008
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Provider Practice Location Address
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Address Line | 3143 STATE RD SUITE 203
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City | LA CROSSE
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State | WI
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Zip | 54601-6964
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Country | US
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Telephone | 608-788-3838
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Fax | 608-788-9862
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Provider Business Mailing Address
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Address Line | 3143 STATE RD SUITE 203
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City | LA CROSSE
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State | WI
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Zip | 54601-6964
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Country | US
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Telephone | 608-788-3838
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Fax | 608-788-9862
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN ALLAN SCHMIDT
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Credential | D.D.S.
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Telephone | 608-788-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3191015
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License Number State | WI
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