Provider Demographics
NPI:1568800118
Name:SCHWARTZ, JAY B (DDS)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:B
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 1:2774 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3526
Mailing Address - Country:US
Mailing Address - Phone:215-639-2112
Mailing Address - Fax:215-639-5309
Practice Address - Street 1:2774 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3526
Practice Address - Country:US
Practice Address - Phone:215-639-2112
Practice Address - Fax:215-639-5309
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022951-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist