1285745455 NPI number — DR. MARTIN ALAN SWARTZ DDS

Table of content: DR. MARTIN ALAN SWARTZ DDS (NPI 1285745455)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285745455 NPI number — DR. MARTIN ALAN SWARTZ DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWARTZ
Provider First Name:
MARTIN
Provider Middle Name:
ALAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285745455
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 ONEIDA LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-783-0319
Provider Business Mailing Address Fax Number:
954-783-0319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 EAST HALLANDALE BEACH BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 812
Provider Business Practice Location Address City Name:
HALLANDALE BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-456-4411
Provider Business Practice Location Address Fax Number:
954-456-4406
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  8073 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)