Provider Demographics
NPI:1134250608
Name:SWINTOSKY AND PETERS
Entity type:Organization
Organization Name:SWINTOSKY AND PETERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER (CFO)
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-223-0211
Mailing Address - Street 1:1006 LEAWOOD DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601
Mailing Address - Country:US
Mailing Address - Phone:502-223-0211
Mailing Address - Fax:502-875-5567
Practice Address - Street 1:1006 LEAWOOD DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601
Practice Address - Country:US
Practice Address - Phone:502-223-0211
Practice Address - Fax:502-875-5567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWINTOSKY AND PETERS PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58851223G0001X
KY76151223G0001X, 122300000X
KY52031223G0001X
KY39501223G0001X
KY65431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty