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NPI Code Detail

MEDICARE: DR. MAX W. SWENSON D.M.D.

MEDICARE:  DR. MAX W. SWENSON  D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist578AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101611666OTHERAKUNITED CONCORDIA ID #

General Provider Information

NPI Number : 1013029891
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAX W. SWENSON D.M.D.
Provider Business Mailing Address
First Line : 2600 CORDOVA ST STE 200
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2745
Country : US
Telephone Number : 907-276-1712
Fax Number : 907-258-4482
Provider Business Practice Location Address
First Line : 2600 CORDOVA ST STE 200
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2745
Country : US
Telephone Number : 907-276-1712
Fax Number : 907-258-4482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MAX W. SWENSON D.M.D.” Practice Location

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