Provider Demographics
NPI:1407632250
Name:DAPPER DERMATOLOGY
Entity Type:Organization
Organization Name:DAPPER DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SWIGOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-425-2973
Mailing Address - Street 1:544 CREEK POINTE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-0887
Mailing Address - Country:US
Mailing Address - Phone:701-425-2973
Mailing Address - Fax:
Practice Address - Street 1:544 CREEK POINTE DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-0887
Practice Address - Country:US
Practice Address - Phone:701-425-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty