Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 21598 | OH |
NPI | 1134202443 |
---|---|
Provider Name | Dr. Susan N Smith |
First Address | Steubenville, OH 43952-2360 |
Second Address | Steubenville, OH 43952-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 08/07/2007 |