Provider Demographics
NPI:1134282213
Name:STEVEN F. SHWEDEL DDS PC
Entity Type:Organization
Organization Name:STEVEN F. SHWEDEL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHWEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-292-5590
Mailing Address - Street 1:25650 GODDARD RD STE A
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180
Mailing Address - Country:US
Mailing Address - Phone:313-292-5590
Mailing Address - Fax:313-291-1419
Practice Address - Street 1:25650 GODDARD RD STE A
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:313-292-5590
Practice Address - Fax:313-291-1419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI10532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty