Healthcare Provider Details

I. General information

NPI: 1952389744
Provider Name (Legal Business Name): AARON MATTHEW SWENSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TUSKEGEE BLVD
DOVER AFB DE
19902-5300
US

IV. Provider business mailing address

38 DOWNEY OAK CIR
CAMDEN DE
19934-2295
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-2201
  • Fax:
Mailing address:
  • Phone: 302-698-6347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00009642
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: