Provider Demographics
NPI:1982813069
Name:PATRICIA DEGRAW-SCHWARTZ, DDS,INC
Entity Type:Organization
Organization Name:PATRICIA DEGRAW-SCHWARTZ, DDS,INC
Other - Org Name:THE TOOTH SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:CECILE
Authorized Official - Last Name:DEGRAW-SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-282-2490
Mailing Address - Street 1:1122 E LINCOLN AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1907
Mailing Address - Country:US
Mailing Address - Phone:714-282-2490
Mailing Address - Fax:714-282-2494
Practice Address - Street 1:1122 E LINCOLN AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1907
Practice Address - Country:US
Practice Address - Phone:714-282-2490
Practice Address - Fax:714-282-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty