Individual
JORGE RICARDO SWETT TAPIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
321 W DELAWARE ST, DECATUR, MI 49045
(269) 201-5831
Mailing address
321 W DELAWARE ST, DECATUR, MI 49045-1106
(269) 201-5831
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901022808
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
09/05/2018
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