MEDICARE: DR. DONALD WAYNE SWEARINGEN D.D.S.

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	1223G0001X	General Practice Dentistry	4797	OK

General Provider Information

NPI Number	:	1649272220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD WAYNE SWEARINGEN D.D.S.

Provider Business Mailing Address
First Line	:	1704 OLDE TOWNE RD
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-4944
Country	:	US
Telephone Number	:	405-330-2358
Fax Number	:

Provider Business Practice Location Address
First Line	:	11318 N MAY AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-5843
Country	:	US
Telephone Number	:	405-751-8092
Fax Number	:	405-751-8658

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	02/16/2016

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