Individual
DR. EVAN RANDALL SCHMIDT
Active
Individual
DR. EVAN RANDALL SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MSD
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12012798A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012798A
INDIANA DENTAL LICENSE
IN
01
—
1223X0400X
ORTHODONTICS
IN
01
—
1420-51-3376
DRIVERS LICENSE NUMBER
IN
Enumeration date
05/27/2019
Last updated
05/27/2019
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