Provider Demographics
NPI:1891780433
Name:TO-SCHWALBACH, HIEN LONG (DDS)
Entity Type:Individual
Prefix:MRS
First Name:HIEN
Middle Name:LONG
Last Name:TO-SCHWALBACH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BADGER DR
Mailing Address - Street 2:
Mailing Address - City:LAKE MILLS
Mailing Address - State:WI
Mailing Address - Zip Code:53551-1774
Mailing Address - Country:US
Mailing Address - Phone:262-751-2081
Mailing Address - Fax:
Practice Address - Street 1:6420 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-6592
Practice Address - Country:US
Practice Address - Phone:608-222-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND117751223G0001X
ORD88381223G0001X
WI6343-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice