Provider Demographics
NPI:1053785782
Name:UNIQUELY YOU ORTHODONTICS
Entity type:Organization
Organization Name:UNIQUELY YOU ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:262-644-7400
Mailing Address - Street 1:100 E COMMERCE BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9748
Mailing Address - Country:US
Mailing Address - Phone:262-644-7400
Mailing Address - Fax:
Practice Address - Street 1:100 E COMMERCE BLVD
Practice Address - Street 2:STE B
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9748
Practice Address - Country:US
Practice Address - Phone:262-644-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7036-151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty