Provider Demographics
NPI:1063168789
Name:SCHWARTZ DENTAL, PLLC
Entity type:Organization
Organization Name:SCHWARTZ DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:GRAYCE
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:651-608-9502
Mailing Address - Street 1:7770 DELL RD STE 160
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-9320
Mailing Address - Country:US
Mailing Address - Phone:952-944-3411
Mailing Address - Fax:952-914-0571
Practice Address - Street 1:7770 DELL RD STE 160
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9320
Practice Address - Country:US
Practice Address - Phone:952-944-3411
Practice Address - Fax:952-914-0571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental