Provider Demographics
NPI:1801154844
Name:SCOTT C SCHWARTZ, D.D.S., PC.
Entity type:Organization
Organization Name:SCOTT C SCHWARTZ, D.D.S., PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-667-0070
Mailing Address - Street 1:1476 DEER PARK AVE,
Mailing Address - Street 2:STE 1
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1200
Mailing Address - Country:US
Mailing Address - Phone:631-667-0070
Mailing Address - Fax:631-667-0075
Practice Address - Street 1:1476 DEER PARK AVE STE 1
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1200
Practice Address - Country:US
Practice Address - Phone:631-667-0070
Practice Address - Fax:631-667-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0426331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty