Individual
DR. DONALD JAY SWIERENGA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6267
(618) 256-7931
Mailing address
1221 LAKEVIEW LN, O FALLON, IL 62269-7132
(618) 628-9548
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTH000
MILITARY TREATMENT FACILI
IL
Enumeration date
12/31/2005
Last updated
07/08/2007
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