Provider Demographics
NPI:1497770606
Name:SCHWARTZ, DAVID ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-2332
Mailing Address - Country:US
Mailing Address - Phone:610-670-6910
Mailing Address - Fax:
Practice Address - Street 1:701 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-2332
Practice Address - Country:US
Practice Address - Phone:610-670-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-027306-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA181597OtherBLUE SHIELD PROVIDER #
PADS-027306-LOtherSTATE LICENSE NUMBER