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Individual

DR. JIMMY DEAN SWAN II

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6401 NW EXPRESSWAY, SUITE 132, OKLAHOMA CITY, OK 73132-5170
(405) 728-2828
(405) 720-2929
Mailing address
6401 NW EXPRESSWAY, SUITE 132, OKLAHOMA CITY, OK 73132-5170
(405) 728-2828
(405) 720-2929

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5498
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030704
TRICARE CONCORDIA
OK
01
2305498
DELTA
OK
Enumeration date
09/16/2005
Last updated
07/08/2007
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