Dr. Bradley Richard Swanson
Endodontist
54505 26th Street Unit E
South Bend
, Indiana 46635
Dr. Bradley Richard Swanson
Endodontist
54505 26th Street Unit E
South Bend
, Indiana 46635
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Bradley Richard Swanson
- 3316 S. Twyckenham Drive
- South Bend, IN
- Zip : 46614
- Phone :
Second Address
- Dr. Bradley Richard Swanson
- 54505 26th Street Unit E
- South Bend, IN
- Zip : 46635
- Phone : (574) 807-9050
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 12010670A | IN |
National Provider Identifier
| NPI | 1013033794 |
|---|---|
| Provider Name | Dr. Bradley Richard Swanson |
| First Address | South Bend, IN 46614 |
| Second Address | South Bend, IN 46635 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/03/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.