Healthcare Provider Details

I. General information

NPI: 1881827046
Provider Name (Legal Business Name): JENNY SWARTZ WESTON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNY JAY SWARTZ DDS

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 PASTEUR DR STE 101
GREENSBORO NC
27403-1120
US

IV. Provider business mailing address

612 PASTEUR DR STE 101
GREENSBORO NC
27403-1120
US

V. Phone/Fax

Practice location:
  • Phone: 336-292-1990
  • Fax: 336-292-4738
Mailing address:
  • Phone: 336-292-1990
  • Fax: 336-292-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number8784
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8784
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: