Healthcare Provider Details

I. General information

NPI: 1629295530
Provider Name (Legal Business Name): SWATI MALHOTRA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 S 25TH ST
EASTON PA
18045-5376
US

IV. Provider business mailing address

PO BOX 3189
SYRACUSE NY
13220-3189
US

V. Phone/Fax

Practice location:
  • Phone: 610-330-9855
  • Fax: 610-330-9036
Mailing address:
  • Phone: 315-454-6000
  • Fax: 315-454-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS037044
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS037044
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: