Provider Demographics
NPI:1497008510
Name:SWARTZ, REBECCA (DMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E VENICE AVE UNIT 203
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1664
Mailing Address - Country:US
Mailing Address - Phone:941-497-5451
Mailing Address - Fax:941-484-8444
Practice Address - Street 1:1500 E VENICE AVE UNIT 203
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1664
Practice Address - Country:US
Practice Address - Phone:941-497-5451
Practice Address - Fax:941-484-8444
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN160791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice