Provider Demographics
NPI:1043244718
Name:SCHWARTZ, MICHAEL KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KENT
Last Name:SCHWARTZ
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 1:10 WARREN RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2506
Mailing Address - Country:US
Mailing Address - Phone:410-666-5225
Mailing Address - Fax:410-666-7220
Practice Address - Street 1:10 WARREN RD
Practice Address - Street 2:SUITE 330
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-2506
Practice Address - Country:US
Practice Address - Phone:410-666-5225
Practice Address - Fax:410-666-7220
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD83201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK551Medicare ID - Type UnspecifiedCURRENT MEDICARE ID #
MDT59907Medicare UPIN