Provider Demographics
NPI:1841327244
Name:SCHWARZ, MICHAEL BRIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:SCHWARZ
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 1:18 MASSA LN
Mailing Address - Street 2:APT D6
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1552
Mailing Address - Country:US
Mailing Address - Phone:201-868-9565
Mailing Address - Fax:
Practice Address - Street 1:8534 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4369
Practice Address - Country:US
Practice Address - Phone:201-868-9565
Practice Address - Fax:201-868-1055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0174011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice