Healthcare Provider Details

I. General information

NPI: 1497067698
Provider Name (Legal Business Name): SARAH ELIZABETH SWENSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH MURRELL DDS

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1962 1ST AVENUE NE
CEDAR RAPIDS IA
52402-5334
US

IV. Provider business mailing address

2656 COUNTRY CLUB PKWY SE
CEDAR RAPIDS IA
52403-1643
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-2413
  • Fax: 319-364-8179
Mailing address:
  • Phone: 319-531-0963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number08765
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: