Provider Demographics
NPI:1134211469
Name:SWINK, JOSEPH FRANKLIN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANKLIN
Last Name:SWINK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S DORITY ST
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-2819
Mailing Address - Country:US
Mailing Address - Phone:918-967-3346
Mailing Address - Fax:918-967-3339
Practice Address - Street 1:103 S DORITY ST
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2819
Practice Address - Country:US
Practice Address - Phone:918-967-3346
Practice Address - Fax:918-967-3339
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100079960AMedicaid