Provider Demographics
NPI:1043365836
Name:SWORDS, PHILIP G (DMD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:G
Last Name:SWORDS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RUTH DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1339
Mailing Address - Country:US
Mailing Address - Phone:770-253-3171
Mailing Address - Fax:770-253-9892
Practice Address - Street 1:56 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1947
Practice Address - Country:US
Practice Address - Phone:770-253-2802
Practice Address - Fax:770-252-9304
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA108281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice