Provider Demographics
NPI:1407266554
Name:JAMES SCHWARTZ, DDS, PA
Entity Type:Organization
Organization Name:JAMES SCHWARTZ, DDS, PA
Other - Org Name:CAROLINA DENTISTRY @ THE STATELINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-752-7602
Mailing Address - Street 1:17214 LANCASTER HWY STE 306
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2093
Mailing Address - Country:US
Mailing Address - Phone:704-752-7602
Mailing Address - Fax:
Practice Address - Street 1:17214 LANCASTER HWY STE 306
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2093
Practice Address - Country:US
Practice Address - Phone:704-752-7602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental