Provider Demographics
NPI:1952401523
Name:SCHWARTZ, STEPHEN NICHOLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NICHOLAS
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-2540
Mailing Address - Country:US
Mailing Address - Phone:507-373-5658
Mailing Address - Fax:507-373-0489
Practice Address - Street 1:223 E WILLIAM ST
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-2540
Practice Address - Country:US
Practice Address - Phone:507-373-5658
Practice Address - Fax:507-373-0489
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist