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NPI Code Detail

MEDICARE: CHRISTINE SMITH

MEDICARE: CHRISTINE SMITH
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
1124Q00000XDental HygienistDH10076FL

General Provider Information

NPI Number : 1710022561
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE SMITH
Provider Business Mailing Address
First Line : 9808 INDIAN KEY TRL
Second Line :
City : SEMINOLE
State : FL
Zip : 33776-1068
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 8TH AVE SE
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33701-5030
Country : US
Telephone Number : 727-502-1586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ CHRISTINE SMITH ” Practice Location

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