Provider Demographics
NPI:1508985391
Name:SWONKE, PATRIFCK LEON (DDS, PC)
Entity Type:Individual
Prefix:
First Name:PATRIFCK
Middle Name:LEON
Last Name:SWONKE
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8687 LOUETTA RD
Mailing Address - Street 2:STE. 250
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6672
Mailing Address - Country:US
Mailing Address - Phone:281-379-1021
Mailing Address - Fax:281-379-2406
Practice Address - Street 1:8687 LOUETTA RD
Practice Address - Street 2:STE. 250
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6672
Practice Address - Country:US
Practice Address - Phone:281-379-1021
Practice Address - Fax:281-379-2406
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152151223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics