Provider Demographics
NPI:1548644461
Name:JAMES A. SWEENEY DDS, A DENTAL CORPORATION
Entity type:Organization
Organization Name:JAMES A. SWEENEY DDS, A DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-947-6905
Mailing Address - Street 1:16385 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-3623
Mailing Address - Country:US
Mailing Address - Phone:760-947-6905
Mailing Address - Fax:760-513-9860
Practice Address - Street 1:16385 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3623
Practice Address - Country:US
Practice Address - Phone:760-947-6905
Practice Address - Fax:760-513-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty