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NPI Code Detail

MEDICARE: DR. CRAIG LOT SMITH D.D.S.

MEDICARE: DR. CRAIG LOT SMITH D.D.S.
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
11223G0001XGeneral Practice DentistryDR60171701WA
21223G0001XGeneral Practice DentistryDE60174659WA

General Provider Information

NPI Number : 1558673806
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG LOT SMITH D.D.S.
Provider Business Mailing Address
First Line : 2501 N PEARL ST
Second Line :
City : TACOMA
State : WA
Zip : 98406-2540
Country : US
Telephone Number : 206-940-4456
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N PEARL ST
Second Line :
City : TACOMA
State : WA
Zip : 98406-2540
Country : US
Telephone Number : 206-940-4456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2010
Last Update Date : 01/26/2012

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