Provider Demographics
NPI:1073351797
Name:SWANTEK DENTAL PLLC
Entity type:Organization
Organization Name:SWANTEK DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWANTEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-871-3291
Mailing Address - Street 1:659 JOHN M AVE
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-2711
Mailing Address - Country:US
Mailing Address - Phone:248-217-0973
Mailing Address - Fax:989-871-4583
Practice Address - Street 1:4696 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746-9056
Practice Address - Country:US
Practice Address - Phone:989-871-3291
Practice Address - Fax:989-871-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty