MEDICARE: DR. JAMES CLARK MCSWINEY DDS

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
1	122300000X	Dentist	9570	GA

General Provider Information

NPI Number	:	1073899316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES CLARK MCSWINEY DDS

Provider Business Mailing Address
First Line	:	3200 COBB GALLERIA PKWY STE 110
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5919
Country	:	US
Telephone Number	:	770-988-0047
Fax Number	:	770-988-0096

Provider Business Practice Location Address
First Line	:	3200 COBB GALLERIA PKWY STE 110
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5919
Country	:	US
Telephone Number	:	770-988-0047
Fax Number	:	770-988-0096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2011
Last Update Date	:	11/01/2011

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