Healthcare Provider Details

I. General information

NPI: 1073895561
Provider Name (Legal Business Name): SWENDA SLEEP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 MCDANIEL DRIVE
WEST CHESTER PA
19380
US

IV. Provider business mailing address

1595 MCDANIEL DRIVE
WEST CHESTER PA
19380
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-4642
  • Fax: 610-436-8553
Mailing address:
  • Phone: 610-436-4642
  • Fax: 610-436-8553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS022304L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW E SWENDA JR.
Title or Position: PRESIDENT
Credential: DMD
Phone: 610-436-4642