Brian M Smith, DDS

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Bonsall, CA

NPI 1013046093 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013046093
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
21406 (CA)
Practice address
5256 S Mission Rd Ste 1103
Bonsall, CA 92003-3624
Phone
(760) 630-6494
Fax
(760) 630-6498
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21406 CA Yes

Addresses

Primary practice location

5256 S Mission Rd Ste 1103
Bonsall, CA 92003-3624

Mailing address

5256 S Mission Rd Ste 1103
Bonsall, CA 92003-3624
Phone (760) 630-6494

Other providers in Bonsall, CA

All providers in Bonsall, CA · Oral and Maxillofacial Surgery (Dentist) in California

Sources for this page

Verify at the official NPI Registry.