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NPI Code Detail

MEDICARE: DR. GARY EDWARD SWANSON DDS

MEDICARE:  DR. GARY EDWARD SWANSON  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
11223G0001XGeneral Practice DentistryDN9333FL

General Provider Information

NPI Number : 1568592061
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY EDWARD SWANSON DDS
Provider Business Mailing Address
First Line : 5285 SUMMERLIN RD STE 402
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7601
Country : US
Telephone Number : 239-936-7077
Fax Number : 239-936-8211
Provider Business Practice Location Address
First Line : 5285 SUMMERLIN RD STE 402
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-7601
Country : US
Telephone Number : 239-936-7077
Fax Number : 239-936-8211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ DR. GARY EDWARD SWANSON DDS” Practice Location

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