Provider Demographics
NPI:1811038003
Name:NEAL P. SWANN, DDS, INC.
Entity Type:Organization
Organization Name:NEAL P. SWANN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:SWANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-263-2962
Mailing Address - Street 1:464 E CALAVERAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5412
Mailing Address - Country:US
Mailing Address - Phone:408-263-2962
Mailing Address - Fax:408-263-6703
Practice Address - Street 1:464 E CALAVERAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5412
Practice Address - Country:US
Practice Address - Phone:408-263-2962
Practice Address - Fax:408-263-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267921223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATO8778Medicare UPIN