Provider Demographics
NPI:1174671382
Name:STEPHEN M. SCHWARCZ, D.D.S. AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:STEPHEN M. SCHWARCZ, D.D.S. AND ASSOCIATES, INC.
Other - Org Name:LIFESMILES, SAN PABLO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHWARCZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-232-3143
Mailing Address - Street 1:13925 SAN PABLO AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3652
Mailing Address - Country:US
Mailing Address - Phone:510-232-3143
Mailing Address - Fax:510-232-3709
Practice Address - Street 1:13925 SAN PABLO AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3652
Practice Address - Country:US
Practice Address - Phone:510-232-3143
Practice Address - Fax:510-232-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty