Provider Demographics
NPI:1740943513
Name:SWISH CLINICAL PLLC
Entity type:Organization
Organization Name:SWISH CLINICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:862-216-8108
Mailing Address - Street 1:3415 GREYSTONE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2333
Mailing Address - Country:US
Mailing Address - Phone:862-216-8108
Mailing Address - Fax:
Practice Address - Street 1:111 CO-OP BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2726
Practice Address - Country:US
Practice Address - Phone:512-642-5060
Practice Address - Fax:512-642-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty