MEDICARE: TROY SWIMMER

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	100450	CA

General Provider Information

NPI Number	:	1992129076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY SWIMMER

Provider Business Mailing Address
First Line	:	3572 AVENIDA AMOROSA
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92029-7922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1536 SWEETWATER RD STE E
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-7657
Country	:	US
Telephone Number	:	619-477-4945
Fax Number	:

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

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	09/19/2018

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Directions to “ TROY SWIMMER ” Practice Location

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