Organization
SWANSON AND ASSOCIATES FAMILY DENTISTRY, INC.
Active
Parent organization
SWANSON AND ASSOCIATES FAMILY DENTISTRY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SWANSON AND ASSOCIATES FAMILY DENTISTRY, INC.
Authorized official
DR. BRIAN CHRISTOPHER SWANSON D.D.S. (DENTIST/OWNER)
(262) 644-6951
Entity
Organization
Contact information
Practice address
410 E. WASHINGTON ST., SLINGER, WI 53086
(262) 644-6951
(262) 644-6825
Mailing address
P.O. BOX 379, 410 E. WASHINGTON ST., SLINGER, WI 53086
(262) 644-6951
(262) 644-6825
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3137
WI
1223G0001X
General Practice Dentistry
Primary
6881-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3137
DELTA
WI
05
—
33451600
—
WI
01
—
38395700
MEDICAID GROUP PROVIDER
WI
Enumeration date
11/29/2006
Last updated
06/17/2016
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