Healthcare Provider Details

I. General information

NPI: 1629143870
Provider Name (Legal Business Name): DONALD FREDERICK SWARTZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195A SOUTH LENA ST
RIDGWAY CO
81432-1390
US

IV. Provider business mailing address

PO BOX 1390
RIDGWAY CO
81432-1390
US

V. Phone/Fax

Practice location:
  • Phone: 970-626-3303
  • Fax: 970-626-4469
Mailing address:
  • Phone: 970-626-3303
  • Fax: 970-626-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3699
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: