Provider Demographics
NPI:1366564965
Name:SWANN, WILLIAM F (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:SWANN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4175 N HANSON CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3179
Mailing Address - Country:US
Mailing Address - Phone:301-805-6150
Mailing Address - Fax:301-805-6849
Practice Address - Street 1:4175 N HANSON CT
Practice Address - Street 2:SUITE 300
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3179
Practice Address - Country:US
Practice Address - Phone:301-805-6150
Practice Address - Fax:301-805-6849
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice