Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5890 | LA |
NPI | 1013179076 |
---|---|
Provider Name | Dr. Steven Arthur Swan |
First Address | Youngsville, LA 70592-5491 |
Second Address | New Iberia, LA 70563-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 04/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1893170 | (05) | LA |