Healthcare Provider Details

I. General information

NPI: 1386819456
Provider Name (Legal Business Name): DAVID L. SCHWARTZ D.M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11317 S WESTERN AVE SUTIE 100B
OKLAHOMA CITY OK
73170-5849
US

IV. Provider business mailing address

11317 S WESTERN AVE SUTIE 100B
OKLAHOMA CITY OK
73170-5849
US

V. Phone/Fax

Practice location:
  • Phone: 405-691-0100
  • Fax: 405-691-7892
Mailing address:
  • Phone: 405-691-0100
  • Fax: 405-691-7892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5004
License Number StateOK

VIII. Authorized Official

Name: MRS. APRIL SHORT
Title or Position: OFFICE MANAGER
Credential:
Phone: 405-691-0100