Smith, John Patrick
Smith, John Patrick is an individual health care provider with primary practice located at 1114 Ann St Ste 1-Po # 487 , Delavan WI 53115-1938. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, John Patrick can be contacted via phone (262) 728-8232.Contact Information
Primary practice address
1114 Ann St Ste 1-Po # 487
Delavan WI 53115-1938
Phone: (262) 728-8232
Fax: (262) 728-8259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3790 | Wisconsin |
Profile Details
| NPI number | 1700974136 |
|---|---|
| LBN Legal business name | Smith, John Patrick |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Oct 2nd, 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 | 1700974136 | NPPES |
| Wisconsin | MEDICAID | 33495800 |
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