Provider Demographics
NPI:1841729472
Name:SCHMITT, TERRY DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:DAVID
Last Name:SCHMITT
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 1:501 S POKEGAMA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3841
Mailing Address - Country:US
Mailing Address - Phone:182-326-3231
Mailing Address - Fax:
Practice Address - Street 1:501 S POKEGAMA AVE STE 101
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3841
Practice Address - Country:US
Practice Address - Phone:218-326-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13859122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist