Provider Demographics
NPI:1548672538
Name:SCHMIDT, SCOTT AARON (DDS)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:AARON
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 1:2720 ANNAPOLIS CIRCLE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441
Mailing Address - Country:US
Mailing Address - Phone:763-546-7707
Mailing Address - Fax:763-546-7713
Practice Address - Street 1:2720 ANNAPOLIS CIRCLE N
Practice Address - Street 2:SUITE A
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441
Practice Address - Country:US
Practice Address - Phone:763-546-7707
Practice Address - Fax:763-546-7713
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13369122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist