Provider Demographics
NPI:1609617604
Name:SCHWARTZ, ADAM FREDERICK (DMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:FREDERICK
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 1:9 COTTONTAIL CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6699
Mailing Address - Country:US
Mailing Address - Phone:727-710-3236
Mailing Address - Fax:
Practice Address - Street 1:102 LUSK DR
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:SC
Practice Address - Zip Code:29696-2629
Practice Address - Country:US
Practice Address - Phone:864-638-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.108021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice