Healthcare Provider Details

I. General information

NPI: 1699419549
Provider Name (Legal Business Name): ROBERT A SCHWEYEN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13240 EUREKA RD
SOUTHGATE MI
48195-1310
US

IV. Provider business mailing address

13240 EUREKA RD
SOUTHGATE MI
48195-1310
US

V. Phone/Fax

Practice location:
  • Phone: 734-282-7880
  • Fax:
Mailing address:
  • Phone: 734-282-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT ANTHONY SCHWEYEN
Title or Position: OWNER
Credential: DDS
Phone: 734-282-7880