Provider Demographics
NPI:1255443685
Name:SWONKE, THOMAS EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:SWONKE
Suffix:
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 1:4724 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5150
Mailing Address - Country:US
Mailing Address - Phone:281-565-0808
Mailing Address - Fax:281-494-2404
Practice Address - Street 1:4724 SWEETWATER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5150
Practice Address - Country:US
Practice Address - Phone:281-565-0808
Practice Address - Fax:281-494-2404
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist