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General NPI Number Information
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NPI Number | 1932274107
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Entity Type | Organization
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Legal Business Name | SWEENDENT P.A.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3548 NOBLE AVE N
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City | CRYSTAL
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State | MN
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Zip | 55422-2866
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Country | US
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Telephone | 763-521-2254
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Fax |
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Provider Business Mailing Address
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Address Line | 3548 NOBLE AVE N
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City | CRYSTAL
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State | MN
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Zip | 55422-2866
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Country | US
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Telephone | 763-521-2254
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DUANE KEITH SWEEN
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Credential | DDS
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Telephone | 763-521-2254
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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 | C960
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License Number State | MN
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