Smith, Mark David
Smith, Mark David is an individual health care provider with primary practice located at 1205 E Ross Bypass , Tahlequah OK 74464. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, Mark David can be contacted via phone (918) 456-2555.Contact Information
Primary practice address
1205 E Ross Bypass
Tahlequah OK 74464
Phone: (918) 456-2555
Fax: (918) 456-2444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5389 | Oklahoma |
Profile Details
| NPI number | 1124096755 |
|---|---|
| LBN Legal business name | Smith, Mark David |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 9th, 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 | 1124096755 | NPPES |
| Oklahoma | MEDICAID | 20020390 |
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