Individual
DR. FREDERICK RAY SWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
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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