Provider Demographics
NPI:1881638484
Name:SCHWERT, JEFFREY ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:SCHWERT
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:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:BLOOMING PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55917-0667
Mailing Address - Country:US
Mailing Address - Phone:507-583-6613
Mailing Address - Fax:507-583-2873
Practice Address - Street 1:132-2ND AVE NE
Practice Address - Street 2:
Practice Address - City:BLOOMING PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55917-0667
Practice Address - Country:US
Practice Address - Phone:507-583-6613
Practice Address - Fax:507-583-2873
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9988122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist