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General NPI Number Information
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NPI Number | 1629086863
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Entity Type | Individual
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Provider Name | RICHARD M SCHWARCZ D.D.S
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 25529 VAN DYKE AVE
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City | CENTER LINE
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State | MI
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Zip | 48015-1848
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Country | US
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Telephone | 586-757-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 26250 RAINE ST
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City | OAK PARK
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State | MI
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Zip | 48237-1058
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Country | US
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Telephone | 586-855-3771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901015063
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License Number State | MI
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