Healthcare Provider Details

I. General information

NPI: 1801916515
Provider Name (Legal Business Name): ROY STUART SCHWARTZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S UNION AVE STE B4010
TACOMA WA
98405-1804
US

IV. Provider business mailing address

1901 S UNION AVE STE B4010
TACOMA WA
98405-1804
US

V. Phone/Fax

Practice location:
  • Phone: 253-272-4067
  • Fax: 253-272-6005
Mailing address:
  • Phone: 253-272-4067
  • Fax: 253-272-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDE00004130
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: