Provider Demographics
NPI:1699868281
Name:SCHMIDT, ROBERT VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VINCENT
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5394 VALLEY MIST TRACE
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1643
Mailing Address - Country:US
Mailing Address - Phone:770-242-8824
Mailing Address - Fax:404-874-1512
Practice Address - Street 1:620 PEACHTREE STREET
Practice Address - Street 2:STE #204
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-872-7755
Practice Address - Fax:404-874-1512
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist