Individual
DR. EDWARD KENNETH SWAIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
750 PARK AVE, SUITE 1A/1B, NEW YORK, NY 10021-4252
(212) 861-7979
(212) 861-5018
Mailing address
750 PARK AVE, SUITE 1A/1B, NEW YORK, NY 10021-4252
(212) 861-7979
(212) 861-5018
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
028871
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00284340
—
NY
01
—
13-3579806
TAX ID
NY
Enumeration date
09/29/2006
Last updated
06/09/2011
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