Individual
DR. MARVIN ALLEN SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
242 CENTRAL AVE, GRANT, NE 69140-0863
(308) 352-4241
(308) 352-4113
Mailing address
PO BOX 863, GRANT, NE 69140-0863
(308) 352-4241
(308) 352-4113
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4779
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47061400900
—
NE
Enumeration date
09/07/2006
Last updated
07/08/2007
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