Provider Demographics
NPI:1538977467
Name:SWANSON & STRUPP FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:SWANSON & STRUPP FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:STRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:262-644-6951
Mailing Address - Street 1:410 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9650
Mailing Address - Country:US
Mailing Address - Phone:262-644-6951
Mailing Address - Fax:262-644-6825
Practice Address - Street 1:410 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9650
Practice Address - Country:US
Practice Address - Phone:262-644-6951
Practice Address - Fax:262-644-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental