Provider Demographics
NPI:1518928910
Name:SWAUGER, KURT ROBERT (DR DDS)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:ROBERT
Last Name:SWAUGER
Suffix:
Gender:M
Credentials:DR DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LENTZ DR
Mailing Address - Street 2:STE 40
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5135
Mailing Address - Country:US
Mailing Address - Phone:615-868-9057
Mailing Address - Fax:615-868-0234
Practice Address - Street 1:500 LENTZ DR
Practice Address - Street 2:STE 40
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5135
Practice Address - Country:US
Practice Address - Phone:615-868-9057
Practice Address - Fax:615-868-0234
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry