MEDICARE: JOHN C SWEARINGEN

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	1223G0001X	General Practice Dentistry	28496	CA

General Provider Information

NPI Number	:	1881725513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C SWEARINGEN

Provider Business Mailing Address
First Line	:	1600 COLORADO AVE BLDG 3
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-2713
Country	:	US
Telephone Number	:	209-667-0115
Fax Number	:	209-667-2323

Provider Business Practice Location Address
First Line	:	1600 COLORADO AVE BLDG 3
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-2713
Country	:	US
Telephone Number	:	209-667-0115
Fax Number	:	209-667-2323

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	04/06/2015

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