Provider Demographics
NPI:1285813709
Name:SCHWAB, WILLIAM GREGORY (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5132
Mailing Address - Country:US
Mailing Address - Phone:203-324-6171
Mailing Address - Fax:203-348-5392
Practice Address - Street 1:1500 SUMMER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5132
Practice Address - Country:US
Practice Address - Phone:203-324-6171
Practice Address - Fax:203-348-5392
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist