Provider Demographics
NPI:1114024825
Name:SCHWARZ, KURT GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:GORDON
Last Name:SCHWARZ
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 1:18111 PRINCE PHILIP DR STE 208
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1504
Mailing Address - Country:US
Mailing Address - Phone:301-774-4543
Mailing Address - Fax:301-774-4541
Practice Address - Street 1:18111 PRINCE PHILIP DR STE 208
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1504
Practice Address - Country:US
Practice Address - Phone:301-774-4543
Practice Address - Fax:301-774-4541
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD89361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice