Healthcare Provider Details

I. General information

NPI: 1730357740
Provider Name (Legal Business Name): WILLIAM JOSEPH SWIGLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E OCEAN BLVD SUITE #227
STUART FL
34994-2471
US

IV. Provider business mailing address

900 E OCEAN BLVD SUITE #227
STUART FL
34994-2471
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-4610
  • Fax: 772-287-4605
Mailing address:
  • Phone: 772-287-4610
  • Fax: 772-287-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN7616
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: