Provider Demographics
NPI:1770783102
Name:SCHWARTZ, ELI JOSHUA (DMD)
Entity type:Individual
Prefix:DR
First Name:ELI
Middle Name:JOSHUA
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NW 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2369
Mailing Address - Country:US
Mailing Address - Phone:954-583-1152
Mailing Address - Fax:954-583-8977
Practice Address - Street 1:201 NW 70TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2369
Practice Address - Country:US
Practice Address - Phone:954-583-1152
Practice Address - Fax:954-583-8977
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN179931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice