Provider Demographics
NPI:1760702906
Name:SWIHART, JEFFREY AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:AARON
Last Name:SWIHART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21813 STATE ROAD 120
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516
Mailing Address - Country:US
Mailing Address - Phone:574-848-7487
Mailing Address - Fax:
Practice Address - Street 1:21813 STATE ROAD 120
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516
Practice Address - Country:US
Practice Address - Phone:574-848-7487
Practice Address - Fax:219-548-8848
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011431A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice