Provider Demographics
NPI:1629086863
Name:SCHWARCZ, RICHARD M (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:SCHWARCZ
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 1:26250 RAINE ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1058
Mailing Address - Country:US
Mailing Address - Phone:586-855-3771
Mailing Address - Fax:
Practice Address - Street 1:25529 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1848
Practice Address - Country:US
Practice Address - Phone:586-757-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901015063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist