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General NPI Number Information
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NPI Number | 1831472414
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Entity Type | Individual
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Provider Name | TRAVIS C SCHWARZ DMD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 8618 MEXICO RD SUITE 320
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City | O FALLON
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State | MO
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Zip | 63366-7507
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Country | US
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Telephone | 636-205-4045
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Fax | 636-205-4050
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Provider Business Mailing Address
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Address Line | 8618 MEXICO RD SUITE 320
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City | O FALLON
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State | MO
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Zip | 63366-7507
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Country | US
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Telephone | 636-205-4045
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Fax | 636-205-4050
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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 | 2011030941
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License Number State | MO
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