Provider Demographics
NPI:1841388626
Name:SWAIN, LINDA PATTERSON (DDS)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:PATTERSON
Last Name:SWAIN
Suffix:
Gender:F
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:PO BOX 2125
Mailing Address - Street 2:200 LOCKHARD LANE
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-5125
Mailing Address - Country:US
Mailing Address - Phone:252-504-2138
Mailing Address - Fax:252-504-3752
Practice Address - Street 1:200 LOCKHART LN
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1592
Practice Address - Country:US
Practice Address - Phone:252-504-2138
Practice Address - Fax:252-504-3752
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6607122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
90079OtherBXBS
057346OtherTRICARE