Healthcare Provider Details

I. General information

NPI: 1376683326
Provider Name (Legal Business Name): MICHAEL R SCHWARZ DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 PARK AVE
PLAINFIELD NJ
07060-3001
US

IV. Provider business mailing address

923 PARK AVE
PLAINFIELD NJ
07060-3001
US

V. Phone/Fax

Practice location:
  • Phone: 908-754-9373
  • Fax: 908-755-2125
Mailing address:
  • Phone: 908-754-9373
  • Fax: 908-755-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI 15138
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MICHAEL ROBERT SCHWARZ
Title or Position: OWNER
Credential: DDS,FAGD
Phone: 908-754-9373