Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 30017117 | OH |
NPI | 1154763613 |
---|---|
Provider Name | Linda A Smith |
First Address | Cincinnati, OH 45229-3014 |
Second Address | Cincinnati, OH 45229-3014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2013 |
Last Update Date | 25/07/2013 |