MEDICARE: DR. KEVIN CHRISTOPHER SWEENEY 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	1223P0300X	Periodontics	0401005383	VA

General Provider Information

NPI Number	:	1093927295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN CHRISTOPHER SWEENEY DDS

Provider Business Mailing Address
First Line	:	8530 MAYLAND DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4700
Country	:	US
Telephone Number	:	804-270-3131
Fax Number	:

Provider Business Practice Location Address
First Line	:	8530 MAYLAND DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4700
Country	:	US
Telephone Number	:	804-270-3131
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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