Provider Demographics
NPI:1891143426
Name:GARRETT R SWANSON DMD, PC
Entity Type:Organization
Organization Name:GARRETT R SWANSON DMD, PC
Other - Org Name:SWANSON DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:775-825-9225
Mailing Address - Street 1:175 BRINKBY AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4327
Mailing Address - Country:US
Mailing Address - Phone:775-825-9225
Mailing Address - Fax:775-825-9366
Practice Address - Street 1:175 BRINKBY AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4327
Practice Address - Country:US
Practice Address - Phone:775-825-9225
Practice Address - Fax:775-825-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty