Provider Demographics
NPI:1477869634
Name:SWETA TAILOR, DDS, PLLC
Entity Type:Organization
Organization Name:SWETA TAILOR, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF PLLC
Authorized Official - Prefix:DR
Authorized Official - First Name:SWETA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAILOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-458-1133
Mailing Address - Street 1:4105 MEDICAL PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-458-1133
Mailing Address - Fax:512-458-1135
Practice Address - Street 1:4105 MEDICAL PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756
Practice Address - Country:US
Practice Address - Phone:512-458-1133
Practice Address - Fax:512-458-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty