Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 23381 | CA |
NPI | 1033237680 |
---|---|
Provider Name | Dr. James Michael Smyrak |
First Address | Belmont, CA 94002-1615 |
Second Address | Belmont, CA 94002-1615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |