Provider Demographics
NPI:1154615847
Name:SWINGDORF, AARON BRADLEY (DDS)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:BRADLEY
Last Name:SWINGDORF
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 1:600 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2755
Mailing Address - Country:US
Mailing Address - Phone:507-645-5264
Mailing Address - Fax:507-663-0303
Practice Address - Street 1:600 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2755
Practice Address - Country:US
Practice Address - Phone:507-645-5264
Practice Address - Fax:507-663-0303
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist