Provider Demographics
NPI:1558468645
Name:PHILIP M. SCHWARTZ, P.A.
Entity type:Organization
Organization Name:PHILIP M. SCHWARTZ, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-652-7110
Mailing Address - Street 1:339 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1533
Mailing Address - Country:US
Mailing Address - Phone:201-652-7110
Mailing Address - Fax:201-652-8983
Practice Address - Street 1:339 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1533
Practice Address - Country:US
Practice Address - Phone:201-652-7110
Practice Address - Fax:201-652-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101136801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty