Provider Demographics
NPI:1942305925
Name:SCHWARZ, EVAN B (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:B
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CENTRAL PARK SOUTH
Mailing Address - Street 2:SUITE 10B
Mailing Address - City:NY
Mailing Address - State:NJ
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-753-3450
Mailing Address - Fax:212-319-5277
Practice Address - Street 1:30 CENTRAL PARK SOUTH
Practice Address - Street 2:SUITE 10B
Practice Address - City:NY
Practice Address - State:NJ
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-753-3450
Practice Address - Fax:212-319-5277
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023114001223P0700X
NY0509421223P0700X
NY050942-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics