Provider Demographics
NPI:1407994304
Name:REPASKY & SWARTS P.C.
Entity Type:Organization
Organization Name:REPASKY & SWARTS P.C.
Other - Org Name:DUNDEE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:REPASKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:734-529-3031
Mailing Address - Street 1:424 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:MI
Mailing Address - Zip Code:48131-1380
Mailing Address - Country:US
Mailing Address - Phone:734-529-3031
Mailing Address - Fax:734-529-5827
Practice Address - Street 1:424 E MONROE ST
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:MI
Practice Address - Zip Code:48131-1380
Practice Address - Country:US
Practice Address - Phone:734-529-3031
Practice Address - Fax:734-529-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI105381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID8023707OtherBLUE CROSS BLUE SHIELD
MI896808OtherUNITED CONCORDIA PROVIDER