Provider Demographics
NPI:1902399520
Name:SWENSON, MADELINE ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:ANNE
Last Name:SWENSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 WESTOWN PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7708
Mailing Address - Country:US
Mailing Address - Phone:515-223-9700
Mailing Address - Fax:
Practice Address - Street 1:6600 WESTOWN PKWY STE 170
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7708
Practice Address - Country:US
Practice Address - Phone:515-223-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAFS03574351223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics