Organization
DRS SWANN & TALLENT, PA
Active
Other names
Southeast Oral & Maxillofacial Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DENNIS SWANN DMD (DOCTOR)
(704) 541-3603
Entity
Organization
Contact information
Practice address
3111 SPRINGBANK LANE, SUITE A, CHARLOTTE, NC 28226
(704) 541-3603
(704) 541-3619
Mailing address
3111 SPRINGBANK LANE, SUITE A, CHARLOTTE, NC 28226
(704) 541-3603
(704) 541-3619
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
3793
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
5881
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
5962
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
9535
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01083
BCBS
—
01
—
0607286
AETNA
—
05
—
8901083
—
NC
Enumeration date
06/04/2006
Last updated
09/06/2023
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