MEDICARE: DR. MARY KREMPASKY SMITH DDS

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	DE00005759	WA

General Provider Information

NPI Number	:	1356355382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY KREMPASKY SMITH DDS

Provider Business Mailing Address
First Line	:	6817 N CEDAR RD STE 101
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4277
Country	:	US
Telephone Number	:	509-325-0233
Fax Number	:	509-325-7635

Provider Business Practice Location Address
First Line	:	6817 N CEDAR RD STE 101
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4277
Country	:	US
Telephone Number	:	509-325-0233
Fax Number	:	509-325-7635

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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