Provider Demographics
NPI:1861437014
Name:SCHWARTZ, RONALD L I (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:SCHWARTZ
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1014
Mailing Address - Country:US
Mailing Address - Phone:716-282-1402
Mailing Address - Fax:716-284-7979
Practice Address - Street 1:604 4TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1014
Practice Address - Country:US
Practice Address - Phone:716-282-1402
Practice Address - Fax:716-284-7979
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00901400Medicaid