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General NPI Number Information
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NPI Number | 1134199003
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Entity Type | Individual
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Provider Name | GARY DANIEL SWIEC DDS
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 650 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21201
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Country | US
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Telephone | 410-706-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 6208 WAVING WILLOW PATH
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City | CLARKSVILLE
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State | MD
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Zip | 21029-2101
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Country | US
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Telephone | 706-231-6974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 9520
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9520
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License Number State | MD
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