Glenn Douglas Smiley, DDS

Individual provider Active NPI General Practice Dentistry · Smithfield, PA

NPI 1043393606 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043393606
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS023229L (PA)
Practice address
3090 Morgantown Rd
Smithfield, PA 15478
Phone
(724) 569-4400
Fax
(724) 569-1742
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS023229LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS023229L PA Yes

Addresses

Primary practice location

3090 Morgantown Rd
Smithfield, PA 15478

Mailing address

3090 Morgantown Rd
Smithfield, PA 15478
Phone (724) 569-4400

Other providers in Smithfield, PA

All providers in Smithfield, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.