Provider Demographics
NPI:1285203729
Name:SWINNEY, MADELYN ELAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MADELYN
Middle Name:ELAINE
Last Name:SWINNEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9327 PROCLAMATION DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2868
Mailing Address - Country:US
Mailing Address - Phone:512-557-4977
Mailing Address - Fax:
Practice Address - Street 1:310 STAGECOACH TRL STE 700
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5151
Practice Address - Country:US
Practice Address - Phone:512-396-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-20
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice