Healthcare Provider Details

I. General information

NPI: 1013179076
Provider Name (Legal Business Name): STEVEN ARTHUR SWAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N LEWIS ST
NEW IBERIA LA
70563-2045
US

IV. Provider business mailing address

204 BROOKHAVEN DR
YOUNGSVILLE LA
70592-5491
US

V. Phone/Fax

Practice location:
  • Phone: 337-256-8658
  • Fax:
Mailing address:
  • Phone: 337-280-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number5890
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: