Provider Demographics
NPI:1194988295
Name:SWAINSTON, ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SWAINSTON
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 1:1530 BAKER ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3752
Mailing Address - Country:US
Mailing Address - Phone:714-556-5636
Mailing Address - Fax:714-556-9100
Practice Address - Street 1:1530 BAKER ST
Practice Address - Street 2:SUITE D
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3752
Practice Address - Country:US
Practice Address - Phone:714-556-5636
Practice Address - Fax:714-556-9100
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice