Healthcare Provider Details

I. General information

NPI: 1336338193
Provider Name (Legal Business Name): SHUMAN & SCHWAB, DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 PARK RD
BLANDON PA
19510-9563
US

IV. Provider business mailing address

109 ANNA AVE P.O. BOX 260
BLANDON PA
19510-9311
US

V. Phone/Fax

Practice location:
  • Phone: 610-926-1233
  • Fax: 610-916-7640
Mailing address:
  • Phone: 610-926-1233
  • Fax: 610-916-7640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS036817
License Number StatePA

VIII. Authorized Official

Name: DR. BRIAN M SCHWAB
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 610-926-1233