Provider Demographics
NPI:1568518058
Name:SWALLOW, DEBORAH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:SWALLOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 YGNACIO VALLEY RD STE E202
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3338
Mailing Address - Country:US
Mailing Address - Phone:925-933-0677
Mailing Address - Fax:925-933-2698
Practice Address - Street 1:2121 YGNACIO VALLEY RD STE E202
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3338
Practice Address - Country:US
Practice Address - Phone:925-933-0677
Practice Address - Fax:925-933-2698
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice