Provider Demographics
NPI:1508953233
Name:SWORDS AND PHELPS
Entity Type:Organization
Organization Name:SWORDS AND PHELPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:I
Authorized Official - Last Name:SWORDS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-479-3713
Mailing Address - Street 1:205 WALESKA RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-2493
Mailing Address - Country:US
Mailing Address - Phone:770-479-3713
Mailing Address - Fax:770-479-4031
Practice Address - Street 1:205 WALESKA RD STE 2A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2493
Practice Address - Country:US
Practice Address - Phone:770-479-3713
Practice Address - Fax:770-479-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty