Waseca Family Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10406 Issued in MN

Legal business name

WASECA FAMILY DENTISTRY, PA

Practice address

118 State St N
Waseca, MN 56093-2929

Phone

(507) 835-3050

Fax

(507) 835-9809

NPI assigned

May 29, 2008

Last updated

May 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gene Williams Swain Jr., D.D.S.

Title

Owner

Phone

(507) 835-3050

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1538327291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 STATE ST N",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "560932929",
            "telephone_number": "507-835-3050",
            "fax_number": "507-835-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 STATE ST N",
            "city": "WASECA",
            "state": "MN",
            "postal_code": "560932929",
            "telephone_number": "507-835-3050",
            "fax_number": "507-835-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASECA FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "SWAIN",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-835-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrant Family Wellness LLC (Vibrant Family Chiropractic)
• Walmart Inc. (Walmart Pharmacy 10-1038)
• Waseca County Human Service
• Waseca Dental Care, P.L.L.C.
• Waseca Family Chiropractic Clinic Inc.
• Waseca Integrated Therapy Hub, LLC
• Waseca Optometric Center
• Breanna Weisbrod, APRN
• Brett David Wickersheim, D.D.S.
• Jesse Ryan Wilder

• General Practice Dentistry in Waseca, MN
• Providers in Waseca, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.