Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS037153 | PA |
NPI | 1043440589 |
---|---|
Provider Name | Dr. Andrea Lynn Smith |
First Address | Reading, PA 19606-2325 |
Second Address | Elverson, PA 19520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2009 |
Last Update Date | 03/11/2009 |