Provider Demographics
NPI:1548499577
Name:SCHMIDL, CARLA SICILIA (DDS)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:SICILIA
Last Name:SCHMIDL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 SHENANDOAH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5231
Mailing Address - Country:US
Mailing Address - Phone:214-507-2480
Mailing Address - Fax:
Practice Address - Street 1:1501 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5231
Practice Address - Country:US
Practice Address - Phone:214-507-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-12
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248401223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry