Provider Demographics
NPI:1679682645
Name:SWEENY, HENRY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:SWEENY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10860 SE COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420
Mailing Address - Country:US
Mailing Address - Phone:352-288-0703
Mailing Address - Fax:352-288-2373
Practice Address - Street 1:10600 SE HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420
Practice Address - Country:US
Practice Address - Phone:352-245-1188
Practice Address - Fax:352-245-1107
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN93361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice