Provider Demographics
NPI:1407176530
Name:SWARTZ, LARKIN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARKIN
Middle Name:PATRICK
Last Name:SWARTZ
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 1:313 REDMOND RD NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1539
Mailing Address - Country:US
Mailing Address - Phone:706-234-3996
Mailing Address - Fax:706-234-2300
Practice Address - Street 1:313 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1539
Practice Address - Country:US
Practice Address - Phone:706-234-3996
Practice Address - Fax:706-234-2300
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003128264AMedicaid