Provider Demographics
NPI:1619959426
Name:DR JAMES R SCHWARTZ DDS PA
Entity Type:Organization
Organization Name:DR JAMES R SCHWARTZ DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:952-474-5041
Mailing Address - Street 1:17809 HUTCHINS DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4100
Mailing Address - Country:US
Mailing Address - Phone:952-474-5041
Mailing Address - Fax:952-401-1608
Practice Address - Street 1:17809 HUTCHINS DR
Practice Address - Street 2:SUITE 108
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4100
Practice Address - Country:US
Practice Address - Phone:952-474-5041
Practice Address - Fax:952-401-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9951122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty