MEDICARE: DR. PIERRE M SMITH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9323	FL

General Provider Information

NPI Number	:	1407993322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIERRE M SMITH DMD

Provider Business Mailing Address
First Line	:	300 W SUNRISE BLVD
Second Line	:	SUITE 11
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6263
Country	:	US
Telephone Number	:	954-523-1054
Fax Number	:	954-525-7184

Provider Business Practice Location Address
First Line	:	300 W SUNRISE BLVD
Second Line	:	SUITE 11
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6263
Country	:	US
Telephone Number	:	954-523-1054
Fax Number	:	954-525-7184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2007

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