Provider Demographics
NPI:1861587545
Name:SCHWARTZ, JAMES ROSS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROSS
Last Name:SCHWARTZ
Suffix:
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 1:17809 HUTCHINS DR STE 108
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4101
Mailing Address - Country:US
Mailing Address - Phone:952-474-1456
Mailing Address - Fax:952-401-1608
Practice Address - Street 1:17809 HUTCHINS DR STE 108
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4101
Practice Address - Country:US
Practice Address - Phone:952-474-1456
Practice Address - Fax:952-401-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND99511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice