Provider Demographics
NPI:1861456949
Name:SCHWARTZ, MARTIN THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:THOMAS
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 1:18 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2718
Mailing Address - Country:US
Mailing Address - Phone:978-256-3171
Mailing Address - Fax:978-244-0497
Practice Address - Street 1:18 NORTH RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2718
Practice Address - Country:US
Practice Address - Phone:978-256-3171
Practice Address - Fax:978-244-0497
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA99501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery