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General NPI Number Information
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NPI Number | 1568504140
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Entity Type | Individual
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Provider Name | SCOTT DAVID SHWEDEL DDS
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 6150 DIAMOND CENTRE CT BUILDING 300, SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33912-4365
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Country | US
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Telephone | 239-243-9238
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Fax | 239-433-5557
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Provider Business Mailing Address
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Address Line | 6150 DIAMOND CENTRE CT BUILDING 300, SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33912-4365
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Country | US
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Telephone | 239-243-9238
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Fax | 239-433-5557
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901019441
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN 19111
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License Number State | FL
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