Healthcare Provider Details

I. General information

NPI: 1386173276
Provider Name (Legal Business Name): LANCE MORRIS SWAPP DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 10/21/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 W BRIGHAM RD STE 15
ST GEORGE UT
84790-7472
US

IV. Provider business mailing address

144 W BRIGHAM RD STE 15
ST GEORGE UT
84790-7472
US

V. Phone/Fax

Practice location:
  • Phone: 435-635-4444
  • Fax:
Mailing address:
  • Phone: 303-898-8967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11176321-9924
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901022217
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: