Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 12961 | MA |
NPI | 1083695019 |
---|---|
Provider Name | Dr. Arthur I. Schwartz |
First Address | Wakefield, MA 01880-1622 |
Second Address | Wakefield, MA 01880-1622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X10173 | BC/BS OF MASS ID# (01) | MA |