Provider Demographics
NPI:1861821001
Name:SMITH, DACIA
Entity Type:Individual
Prefix:
First Name:DACIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 OAKLYNN CT
Mailing Address - Street 2:SUIT 1C
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-4226
Mailing Address - Country:US
Mailing Address - Phone:412-480-3802
Mailing Address - Fax:
Practice Address - Street 1:579 OAKLYNN CT
Practice Address - Street 2:SUIT 1C
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-4226
Practice Address - Country:US
Practice Address - Phone:412-480-3802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies