Healthcare Provider Details

I. General information

NPI: 1528043031
Provider Name (Legal Business Name): CAROL ELAINE BARONE-SMITH D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3D DENTAL BN/USNDC OKINAWA, JAPAN UNIT 38450
FPO AP
96604-8450
JP

IV. Provider business mailing address

PC 557 BOX 480
FPO AP
96379-0480
JP

V. Phone/Fax

Practice location:
  • Phone: 011816117453085
  • Fax: 011816117457387
Mailing address:
  • Phone: 011816117457381
  • Fax: 011816117567387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS-027575L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: