Individual
JUSTIN SWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13603 BARRETT OFFICE DR, SUITE 104, BALLWIN, MO 63021-7828
(314) 822-3868
Mailing address
13603 BARRETT OFFICE DR, SUITE 104, BALLWIN, MO 63021-7828
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014018763
MO
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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