Provider Demographics
NPI:1952112815
Name:SWAY DENTAL & FACIAL ESTHETICS LLC
Entity type:Organization
Organization Name:SWAY DENTAL & FACIAL ESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS, MPH
Authorized Official - Phone:617-894-3438
Mailing Address - Street 1:185 FAIRFIELD AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-6417
Mailing Address - Country:US
Mailing Address - Phone:973-228-2335
Mailing Address - Fax:
Practice Address - Street 1:300 NORTH AVE E
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2488
Practice Address - Country:US
Practice Address - Phone:908-276-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental