MEDICARE: ROBERT BRANTLEY SWINDLE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DN11711	FL

General Provider Information

NPI Number	:	1568508661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT BRANTLEY SWINDLE DMD

Provider Business Mailing Address
First Line	:	1863 BISHOP ESTATES RD
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-4205
Country	:	US
Telephone Number	:	904-265-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 BAYMEADOWS RD
Second Line	:	SUITE 2
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2014
Country	:	US
Telephone Number	:	904-265-1242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/13/2011

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