Provider Demographics
NPI:1831769819
Name:ERIK T SWANSON DDS PC
Entity type:Organization
Organization Name:ERIK T SWANSON DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:T
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-343-5444
Mailing Address - Street 1:3820 JACKSON BLVD
Mailing Address - Street 2:SWANSON DENTAL
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702
Mailing Address - Country:US
Mailing Address - Phone:605-343-5444
Mailing Address - Fax:605-343-0908
Practice Address - Street 1:3820 JACKSON BLVD
Practice Address - Street 2:SWANSON DENTAL
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702
Practice Address - Country:US
Practice Address - Phone:605-343-5444
Practice Address - Fax:605-343-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental