Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 1201 | AZ |
NPI | 1003007097 |
---|---|
Provider Name | Susan J Smedley |
First Address | Tucson, AZ 85734-1589 |
Second Address | Tucson, AZ 85719-5906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 06/08/2007 |