Provider Demographics
NPI:1326487141
Name:SWARTZENTRUBER, CHET (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHET
Middle Name:
Last Name:SWARTZENTRUBER
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 1:2371 FERNWAY DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-1603
Mailing Address - Country:US
Mailing Address - Phone:334-318-2176
Mailing Address - Fax:
Practice Address - Street 1:4146 CARMICHAEL RD
Practice Address - Street 2:SUITE D
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3634
Practice Address - Country:US
Practice Address - Phone:334-270-9924
Practice Address - Fax:334-270-9904
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6008 C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice