Provider Demographics
NPI:1679610992
Name:SCHWARTZ, KEVIN G (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:G
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7705 BRINK RD
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1619
Mailing Address - Country:US
Mailing Address - Phone:301-938-8280
Mailing Address - Fax:301-208-2603
Practice Address - Street 1:1700 S LINCOLN AVE RM 535
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-6115
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010084511223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401008451OtherDENTAL LICENSE