Provider Demographics
NPI:1700974078
Name:SHWEDEL, STEVEN F (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:SHWEDEL
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 1:25650 GODDARD RD
Mailing Address - Street 2:STE A
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180
Mailing Address - Country:US
Mailing Address - Phone:313-292-5590
Mailing Address - Fax:313-291-1419
Practice Address - Street 1:25650 GODDARD RD
Practice Address - Street 2:STE A
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:313-292-5590
Practice Address - Fax:313-291-1419
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI10532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist