Smith, Brian M
Smith, Brian M is an individual health care provider with primary practice located at 101 E Lehigh Ave Pm, Philadelphia PA 19125-1011. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Smith, Brian M can be contacted via phone (215) 707-3613.Contact Information
Primary practice address
101 E Lehigh Ave Pm
Philadelphia PA 19125-1011
Phone: (215) 707-3613
Fax: (215) 707-5405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DS024550L | Pennsylvania |
Profile Details
| NPI number | 1811985948 |
|---|---|
| LBN Legal business name | Smith, Brian M |
| Credentials | DMD MD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Apr 25th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811985948 | NPPES |
| Pennsylvania | MEDICAID | 0012478530006 |
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