Provider Demographics
NPI:1417694977
Name:RENAE SWEENEY DMD, PLLC
Entity Type:Organization
Organization Name:RENAE SWEENEY DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:716-807-2846
Mailing Address - Street 1:8903 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7217
Mailing Address - Country:US
Mailing Address - Phone:954-578-8815
Mailing Address - Fax:954-578-8813
Practice Address - Street 1:8903 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7217
Practice Address - Country:US
Practice Address - Phone:954-578-8815
Practice Address - Fax:954-578-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental