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General NPI Number Information
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NPI Number | 1376616607
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Entity Type | Organization
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Legal Business Name | CLIFFORD J SWANSON DDS PC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 2215 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3891
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Country | US
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Telephone | 847-352-5410
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Fax | 847-352-1809
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Provider Business Mailing Address
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Address Line | 1077 HOLLI CT
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City | SCHAUMBURG
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State | IL
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Zip | 60194-4274
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Country | US
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Telephone | 847-884-8876
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Fax | 847-884-8876
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLIFFORD J SWANSON
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Credential | D.D.S.
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Telephone | 847-884-8876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019018072
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License Number State | IL
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