Provider Demographics
NPI:1912172834
Name:DAVID SCHWARTZ AND DEBRA BLUM DDS PC
Entity Type:Organization
Organization Name:DAVID SCHWARTZ AND DEBRA BLUM DDS PC
Other - Org Name:SCHWARTZ AND BLUM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-268-7400
Mailing Address - Street 1:10721 QUEENS BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4451
Mailing Address - Country:US
Mailing Address - Phone:718-268-7400
Mailing Address - Fax:718-793-2013
Practice Address - Street 1:10721 QUEENS BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4451
Practice Address - Country:US
Practice Address - Phone:718-268-7400
Practice Address - Fax:718-793-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty