MEDICARE: DR. SCOTT ALLEN SCHWARTZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	21664	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	16624502	OTHER	CIDC DENTAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1634811	OTHER	UNITED CONCORDIA
4	88D945	OTHER	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1013015221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALLEN SCHWARTZ DDS

Provider Business Mailing Address
First Line	:	8511 REGIS HEIGHTS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-2336
Country	:	US
Telephone Number	:	210-452-4498
Fax Number	:	210-949-8906

Provider Business Practice Location Address
First Line	:	8410 DATAPOINT DR
Second Line	:	VA DENTAL CLINIC
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3220
Country	:	US
Telephone Number	:	210-949-8900
Fax Number	:	210-949-8906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/16/2013

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