Provider Demographics
NPI:1346548245
Name:W. K. SMITH & J. A. SMITH, PA
Entity Type:Organization
Organization Name:W. K. SMITH & J. A. SMITH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-838-6222
Mailing Address - Street 1:136 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2904
Mailing Address - Country:US
Mailing Address - Phone:410-838-6222
Mailing Address - Fax:410-893-3691
Practice Address - Street 1:136 E BROADWAY
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2904
Practice Address - Country:US
Practice Address - Phone:410-838-6222
Practice Address - Fax:410-893-3691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:W.K. SMITH & J. A. SMITH, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty