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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Bonsall, CA · Oral and Maxillofacial Surgery (Dentist) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.