Provider Demographics
NPI:1487054896
Name:SCHMID, DANIEL (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SCHMID
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13470 N 83RD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4623
Mailing Address - Country:US
Mailing Address - Phone:623-776-1376
Mailing Address - Fax:623-487-5037
Practice Address - Street 1:13470 N 83RD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4623
Practice Address - Country:US
Practice Address - Phone:623-776-1376
Practice Address - Fax:623-487-5037
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist