Provider Demographics
NPI:1750799268
Name:SWAYZE, DANA (DMD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SWAYZE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 E MOCKINGBIRD LN STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0941
Mailing Address - Country:US
Mailing Address - Phone:972-400-3244
Mailing Address - Fax:
Practice Address - Street 1:5330 E MOCKINGBIRD LN STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0941
Practice Address - Country:US
Practice Address - Phone:972-400-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29326122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist