| Brian K. Smith, D.d.s., M.d., Inc. | |
|
14701 Detroit Ave Suite 333 Lakewood OH 44107-4109 | |
| (216) 228-4232 | |
| (216) 228-9136 |
| Full Name | Brian K. Smith, D.d.s., M.d., Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 14701 Detroit Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Brian K Smith (OWNER) |
| Authorized Official Contact | 2162284232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian K. Smith, D.d.s., M.d., Inc. 14701 Detroit Ave Suite 333 Lakewood OH 44107-4109 Ph: (216) 228-4232 | Brian K. Smith, D.d.s., M.d., Inc. 14701 Detroit Ave Suite 333 Lakewood OH 44107-4109 Ph: (216) 228-4232 |
| NPI Number | 1144561002 |
|---|---|
| Provider Enumeration Date | 03/01/2013 |
| Last Update Date | 03/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144561002 | NPI | - | NPPES |
| 2127513 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 3018374 (Ohio) | Primary |
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