Provider Demographics
NPI:1417325390
Name:JOSEPH SCHWARTZ D.D.S PC
Entity Type:Organization
Organization Name:JOSEPH SCHWARTZ D.D.S PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-590-1100
Mailing Address - Street 1:111 W CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2431
Mailing Address - Country:US
Mailing Address - Phone:847-590-1100
Mailing Address - Fax:847-590-1105
Practice Address - Street 1:111 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2431
Practice Address - Country:US
Practice Address - Phone:847-590-1100
Practice Address - Fax:847-590-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019019616122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty