Provider Demographics
NPI:1508431016
Name:SWOGGER, BAILEY OLIVIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:BAILEY
Middle Name:OLIVIA
Last Name:SWOGGER
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 1:662 BECKER RD
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-7520
Mailing Address - Country:US
Mailing Address - Phone:814-937-2418
Mailing Address - Fax:
Practice Address - Street 1:2182 SANDY DR STE 102
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2211
Practice Address - Country:US
Practice Address - Phone:814-234-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist