MEDICARE: ELIZABETH K SCHMAHL DDS PLLC

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	5381	AZ

General Provider Information

NPI Number	:	1285721159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH K SCHMAHL DDS PLLC

Provider Business Mailing Address
First Line	:	3029 SOUTH KINNEY RD
Second Line	:	SUITE B
City	:	TUCSON
State	:	AZ
Zip	:	85713
Country	:	US
Telephone Number	:	520-883-5848
Fax Number	:	520-883-1069

Provider Business Practice Location Address
First Line	:	3029 SOUTH KINNEY RD
Second Line	:	SUITE B
City	:	TUCSON
State	:	AZ
Zip	:	85713
Country	:	US
Telephone Number	:	520-883-5848
Fax Number	:	520-883-1069

Authorized Official
Title or Position	:	DENTIST SELF EMPLOYED
Name	:	DR. ELIZABETH K SCHMAHL
Credential	:	DDS
Telephone Number	:	520-883-5848

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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