Provider Demographics
NPI:1154515088
Name:SCHWARTZ, CARL I (DDS)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:I
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519-1152
Mailing Address - Country:US
Mailing Address - Phone:810-744-3388
Mailing Address - Fax:810-744-4080
Practice Address - Street 1:2414 S CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519-1152
Practice Address - Country:US
Practice Address - Phone:810-744-3388
Practice Address - Fax:810-744-4080
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010090151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice