MEDICARE: PREVICARE, PLLC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1174132559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREVICARE, PLLC

Provider Business Mailing Address
First Line	:	2006 W CAMPBELL RD STE 300
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2315
Country	:	US
Telephone Number	:	972-210-0688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 W CAMPBELL RD STE 300
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2315
Country	:	US
Telephone Number	:	972-210-0688
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MATTHEW SCHWED
Credential	:	DDS
Telephone Number	:	917-974-7993

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	07/30/2020

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