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General NPI Number Information
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NPI Number | 1861771214
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Entity Type | Individual
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Provider Name | JENNIFER D SMITH D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 2003 ROCK SPRING RD
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City | FOREST HILL
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State | MD
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Zip | 21050-2611
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Country | US
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Telephone | 410-838-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 7650 BELAIR RD
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City | BALTIMORE
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State | MD
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Zip | 21236-4088
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Country | US
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Telephone | 410-668-9070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038033
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 14462
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License Number State | MD
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