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NPI Code Detail

MEDICARE: ANDREA LYNN SWAN DDS

MEDICARE: ANDREA LYNN SWAN 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 Dentistry9134NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760778666
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LYNN SWAN DDS
Provider Business Mailing Address
First Line : 105 FIDELITY ST APT A34
Second Line :
City : CARRBORO
State : NC
Zip : 27510-2065
Country : US
Telephone Number : 919-448-8961
Fax Number :
Provider Business Practice Location Address
First Line : 7228 MONCURE PITTSBORO RD
Second Line :
City : MONCURE
State : NC
Zip : 27559-9595
Country : US
Telephone Number : 919-542-1641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2011
Last Update Date : 06/24/2013

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