Provider Demographics
NPI:1023062122
Name:SCHWEIM, BARRY M (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:SCHWEIM
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 1:411 PORPOISE POINT DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2959
Mailing Address - Country:US
Mailing Address - Phone:904-824-4937
Mailing Address - Fax:904-273-5222
Practice Address - Street 1:7000 SAWGRASS VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-5014
Practice Address - Country:US
Practice Address - Phone:904-273-5111
Practice Address - Fax:904-273-5222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL115201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice