Provider Demographics
NPI:1043514201
Name:SMITH, SHEILA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N. 12TH STREET
Mailing Address - Street 2:CMS - ATTENTION: DENTAL DEPARTMENT
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235
Mailing Address - Country:US
Mailing Address - Phone:610-377-7354
Mailing Address - Fax:610-377-7920
Practice Address - Street 1:211 N. 12TH STREET
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235
Practice Address - Country:US
Practice Address - Phone:610-377-7354
Practice Address - Fax:610-377-7920
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024460L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist