Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 08798 | IA |
NPI | 1003142688 |
---|---|
Provider Name | Dr. Nicholas Rindels Smith |
First Address | Ankeny, IA 50023 |
Second Address | Ankeny, IA 50023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2009 |
Last Update Date | 22/12/2011 |