Healthcare Provider Details

I. General information

NPI: 1497044002
Provider Name (Legal Business Name): SAUL SCHWEBER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W BALTIMORE ST DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY
BALTIMORE MD
21201-1510
US

IV. Provider business mailing address

650 W BALTIMORE ST DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY
BALTIMORE MD
21201-1510
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-7060
  • Fax:
Mailing address:
  • Phone: 410-706-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3902
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: