Provider Demographics
NPI:1356457303
Name:SCHWARTZ & GEDEON, DDS,PC
Entity Type:Organization
Organization Name:SCHWARTZ & GEDEON, DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-282-1402
Mailing Address - Street 1:604 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1014
Mailing Address - Country:US
Mailing Address - Phone:716-282-1402
Mailing Address - Fax:716-284-7979
Practice Address - Street 1:604 4TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1014
Practice Address - Country:US
Practice Address - Phone:716-282-1402
Practice Address - Fax:716-284-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02332790Medicaid