Provider Demographics
NPI:1356481345
Name:SWANN, NEAL PERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:PERRY
Last Name:SWANN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 E CALAVERAS BLVD
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5412
Mailing Address - Country:US
Mailing Address - Phone:408-263-2962
Mailing Address - Fax:408-263-6703
Practice Address - Street 1:464 E CALAVERAS BLVD
Practice Address - Street 2:SUITE B-3
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5412
Practice Address - Country:US
Practice Address - Phone:408-263-2962
Practice Address - Fax:408-263-6703
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267921223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATO8778Medicare UPIN