Provider Demographics
NPI:1861653057
Name:SWASTY, DENISE CARROLL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:CARROLL
Last Name:SWASTY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1710 TROLLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8281
Mailing Address - Country:US
Mailing Address - Phone:843-871-8700
Mailing Address - Fax:843-277-0921
Practice Address - Street 1:1710 TROLLEY RD STE A
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8281
Practice Address - Country:US
Practice Address - Phone:843-871-8700
Practice Address - Fax:843-277-0921
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC44391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics