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Organization

BRIAN K. SMITH, D.D.S., M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN K SMITH D,D,S., M.D. (OWNER)
(216) 228-4232
Entity
Organization

Contact information

Practice address
14701 DETROIT AVE, SUITE 333, LAKEWOOD, OH 44107-4109
(216) 228-4232
(216) 228-9136
Mailing address
14701 DETROIT AVE, SUITE 333, LAKEWOOD, OH 44107-4109
(216) 228-4232
(216) 228-9136

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3018374
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2127513
OH
Enumeration date
03/01/2013
Last updated
03/01/2013
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