Provider Demographics
NPI:1467530733
Name:SCHWARTZ, PHILIP E
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:E
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 OLD WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701
Mailing Address - Country:US
Mailing Address - Phone:508-879-8180
Mailing Address - Fax:508-872-4602
Practice Address - Street 1:1283 OLD WORCESTER RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-8906
Practice Address - Country:US
Practice Address - Phone:508-879-8180
Practice Address - Fax:508-872-4602
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice