Provider Demographics
NPI:1821725631
Name:SWATHIFAMILYDENTALLLC
Entity Type:Organization
Organization Name:SWATHIFAMILYDENTALLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:SWATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ATLURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:339-927-0530
Mailing Address - Street 1:2017 SOUTHLAKE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1423
Mailing Address - Country:US
Mailing Address - Phone:339-927-0530
Mailing Address - Fax:
Practice Address - Street 1:3970 N COLLINS STREET
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005
Practice Address - Country:US
Practice Address - Phone:339-927-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental