Provider Demographics
NPI:1932371184
Name:SCHWARZ, PAUL DOUGLAS (DMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DOUGLAS
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:DMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-2228
Mailing Address - Country:US
Mailing Address - Phone:702-372-4073
Mailing Address - Fax:702-361-6291
Practice Address - Street 1:538 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-2228
Practice Address - Country:US
Practice Address - Phone:702-372-4073
Practice Address - Fax:702-361-6291
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACS11721223D0004X
CA1005271223G0001X, 1223S0112X
NV55431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223D0004XDental ProvidersDentistDentist Anesthesiologist
No1223G0001XDental ProvidersDentistGeneral Practice