Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 60256 | KS |
NPI | 1013052273 |
---|---|
Provider Name | Dr. Julie Carol Swift |
First Address | Topeka, KS 66606-1678 |
Second Address | Topeka, KS 66606-1678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |