Provider Demographics
NPI:1376313015
Name:SMESSAERT, NORA RAIN
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:RAIN
Last Name:SMESSAERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:IN
Mailing Address - Zip Code:46506-9209
Mailing Address - Country:US
Mailing Address - Phone:574-276-0990
Mailing Address - Fax:
Practice Address - Street 1:3261 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:IN
Practice Address - Zip Code:46506-9209
Practice Address - Country:US
Practice Address - Phone:574-276-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
No124Q00000XDental ProvidersDental Hygienist