Provider Demographics
NPI:1164757316
Name:SMITH, MARIA-PAZ UGARTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA-PAZ
Middle Name:UGARTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:MARIA-PAZ
Other - Middle Name:UGARTE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:1950 HOLLY COVE ROAD
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-0456
Mailing Address - Country:US
Mailing Address - Phone:757-856-2445
Mailing Address - Fax:757-856-2276
Practice Address - Street 1:1 U S COAST GUARD TRN CTR
Practice Address - Street 2:END OF ROUTE 238
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23690-5001
Practice Address - Country:US
Practice Address - Phone:757-856-2445
Practice Address - Fax:757-856-2276
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029465-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist