Provider Demographics
NPI:1447671144
Name:WILLIAM P. SWETLIK, DDS, MS, SC
Entity type:Organization
Organization Name:WILLIAM P. SWETLIK, DDS, MS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:SWETLIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:715-526-2544
Mailing Address - Street 1:115 ALPINE CT
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-2048
Mailing Address - Country:US
Mailing Address - Phone:715-526-2544
Mailing Address - Fax:715-526-2547
Practice Address - Street 1:115 ALPINE CT
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-2048
Practice Address - Country:US
Practice Address - Phone:715-526-2544
Practice Address - Fax:715-526-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50013581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty