Provider Demographics
NPI:1386819456
Name:DAVID L. SCHWARTZ D.M.D.
Entity type:Organization
Organization Name:DAVID L. SCHWARTZ D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-691-0100
Mailing Address - Street 1:11317 S WESTERN AVE
Mailing Address - Street 2:SUTIE 100B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5849
Mailing Address - Country:US
Mailing Address - Phone:405-691-0100
Mailing Address - Fax:405-691-7892
Practice Address - Street 1:11317 S WESTERN AVE
Practice Address - Street 2:SUTIE 100B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5849
Practice Address - Country:US
Practice Address - Phone:405-691-0100
Practice Address - Fax:405-691-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty