Organization
DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION
Active
Other names
Pasadena Medical/Dental Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICE A WYNDHAMSMITH (OFFICE MANAGER)
(626) 795-9328
Entity
Organization
Contact information
Practice address
1092 E GREEN ST, PASADENA, CA 91106-2506
(626) 395-5140
(626) 395-5144
Mailing address
1092 E GREEN ST, PASADENA, CA 91106-2506
(626) 395-5140
(626) 395-5144
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
46195
CA
1223P0300X
Periodontics
41122
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
49312
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
37519
CA
Other
Enumeration date
05/02/2007
Last updated
10/15/2015
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