Individual
DR. FREDERICK RAY SWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4010 DUPONT CIR, STE 529, LOUISVILLE, KY 40207-4888
(502) 897-3239
(502) 897-3476
Mailing address
4010 DUPONT CIR, STE 529, LOUISVILLE, KY 40207-4888
(502) 897-3239
(502) 897-3476
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4519
KY
1223P0221X
Pediatric Dentistry
Primary
4519
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100010800A
MEDICAL ASSISTANCE
IN
01
—
200448
CRIPPLED CHILDREN'S SERVI
IN
01
—
4507
MEDICAL ASSISTANCE
KY
01
—
60045192
MEDICAL ASSISTANCE
KY
Enumeration date
05/24/2005
Last updated
05/20/2008
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