Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS029427L | PA |
NPI | 1053321380 |
---|---|
Provider Name | Dr. Richard Scott Smith |
First Address | Pittsburgh, PA 15241-1030 |
Second Address | Pittsburgh, PA 15241-1030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |