Provider Demographics
NPI:1447658323
Name:ROBERT M SCHMIDLE DDS
Entity type:Organization
Organization Name:ROBERT M SCHMIDLE DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRIMARY DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHMIDLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-859-1910
Mailing Address - Street 1:313A BLUEBIRD DR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2303
Mailing Address - Country:US
Mailing Address - Phone:615-859-1910
Mailing Address - Fax:615-859-1913
Practice Address - Street 1:313A BLUEBIRD DR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2303
Practice Address - Country:US
Practice Address - Phone:615-859-1910
Practice Address - Fax:615-859-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN74901223G0001X
TN94821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty