Provider Demographics
NPI:1518146182
Name:RICHARD SWATT, D.D.S., INC.
Entity Type:Organization
Organization Name:RICHARD SWATT, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:SWATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-789-0567
Mailing Address - Street 1:4955 VAN NUYS BLVD
Mailing Address - Street 2:SUITE #722
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1801
Mailing Address - Country:US
Mailing Address - Phone:818-789-0567
Mailing Address - Fax:818-789-0519
Practice Address - Street 1:4955 VAN NUYS BLVD
Practice Address - Street 2:SUITE #722
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1801
Practice Address - Country:US
Practice Address - Phone:818-789-0567
Practice Address - Fax:818-789-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26234305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization