MEDICARE: HELAINE SMITH DMD PC

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	17941	MA

General Provider Information

NPI Number	:	1336329531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELAINE SMITH DMD PC

Provider Business Mailing Address
First Line	:	1892 CENTRE ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02132-1924
Country	:	US
Telephone Number	:	617-327-1350
Fax Number	:	617-327-1573

Provider Business Practice Location Address
First Line	:	1892 CENTRE ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02132-1924
Country	:	US
Telephone Number	:	617-327-1350
Fax Number	:	617-327-1573

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HELAINE SMITH
Credential	:	DMD
Telephone Number	:	617-327-1350

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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