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NPI Code Detail

MEDICARE: DR. RICK K SMITH D.D.S

MEDICARE: DR. RICK K 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 Dentistry29867CA

General Provider Information

NPI Number : 1922123009
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICK K SMITH D.D.S
Provider Business Mailing Address
First Line : 8030 SOQUEL AVE
Second Line : SUITE 101
City : SANTA CRUZ
State : CA
Zip : 95062-2096
Country : US
Telephone Number : 831-462-5600
Fax Number : 831-462-0227
Provider Business Practice Location Address
First Line : 8030 SOQUEL AVE
Second Line : SUITE 101
City : SANTA CRUZ
State : CA
Zip : 95062-2096
Country : US
Telephone Number : 831-462-5600
Fax Number : 831-462-0227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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