# SWAPNA RAVEENDRANATH DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740648674
- **Authorized official:** SWAPNA RAVEENDRANATH DDS (CEO)
- **Authorized official phone:** (510) 371-2502

## Contact information

- **Practice address:** 39055 HASTINGS ST, SUITE 203, FREMONT, CA 94538-1518
- **Practice address phone:** (510) 791-3144
- **Practice address fax:** (510) 791-3140
- **Mailing address:** 39055 HASTINGS ST, SUITE 203, FREMONT, CA 94538-1518
- **Mailing address phone:** (510) 791-3144
- **Mailing address fax:** (510) 791-3140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 56777 | CA | Yes |

## Other

- **Enumeration date:** 02/06/2016
- **Last updated:** 02/06/2016