Provider Demographics
NPI:1063429348
Name:SCHWARTZ, JUSTIN IVOR (DMD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:IVOR
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 W ATLANTIC AVE
Mailing Address - Street 2:SUITE W
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4637
Mailing Address - Country:US
Mailing Address - Phone:561-330-8330
Mailing Address - Fax:
Practice Address - Street 1:8440 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2706
Practice Address - Country:US
Practice Address - Phone:954-472-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-07-13
Deactivation Date:2017-06-16
Deactivation Code:
Reactivation Date:2017-07-13
Provider Licenses
StateLicense IDTaxonomies
FLDN173131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics