Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30806 | TX |
N | 1223P0221X | Pediatric Dentist | DN19563 | FL |
NPI | 1104185818 |
---|---|
Provider Name | Dr. Nathifa Smith |
First Address | Hyattsville, MD 20782 |
Second Address | Plano, TX 75024-2409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 29/01/2021 |