Smith, Gary Alfred
Smith, Gary Alfred is an individual health care provider with primary practice located at 2612 W Broadway , Council Bluffs IA 51501-3510. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, Gary Alfred can be contacted via phone (712) 323-3615.Contact Information
Primary practice address
2612 W Broadway
Council Bluffs IA 51501-3510
Phone: (712) 323-3615
Fax: (712) 325-6155
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6699 | Iowa |
Profile Details
| NPI number | 1063441384 |
|---|---|
| LBN Legal business name | Smith, Gary Alfred |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1063441384 | NPPES |
| Pennsylvania | Other | 039537 | UNITED CONCORDIA |
| Pennsylvania | Other | 18575 | UNITED CONCORDIA |
| Pennsylvania | Other | 5334 | UNITED CONCORDIA |
| Pennsylvania | Other | 18575 | UNITED CONCORDIA |
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