Provider Demographics
NPI:1962413351
Name:SCHWARTZ, SIGRID E (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:SIGRID
Middle Name:E
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:SIGRID
Other - Middle Name:E
Other - Last Name:TATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:1200 GAIL GARDNER WAY
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305
Mailing Address - Country:US
Mailing Address - Phone:928-777-8550
Mailing Address - Fax:928-443-0142
Practice Address - Street 1:1200 GAIL GARDNER WAY
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305
Practice Address - Country:US
Practice Address - Phone:928-777-8550
Practice Address - Fax:928-443-0142
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009673A1223X0400X
AZD079271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics