MEDICARE: BRANDON AUSTIN 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	122300000X	Dentist	DN10001024	MA

General Provider Information

NPI Number	:	1871352211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON AUSTIN SMITH DMD

Provider Business Mailing Address
First Line	:	83 W LAKE RD
Second Line	:
City	:	FITZWILLIAM
State	:	NH
Zip	:	03447-3505
Country	:	US
Telephone Number	:	603-933-3622
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 MAIN ST
Second Line	:
City	:	TOWNSEND
State	:	MA
Zip	:	01474-1052
Country	:	US
Telephone Number	:	978-396-9396
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	12/19/2025

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