Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 9520 | MD |
N | 1223P0300X | Periodontist | 9520 | MD |
NPI | 1134199003 |
---|---|
Provider Name | Dr. Gary Daniel Swiec |
First Address | Clarksville, MD 21029-2101 |
Second Address | Baltimore, MD 21201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 12/07/2018 |