| Organization Name: | DR. GARY W. SMART |
| NPI Number: | 1114175122 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY W SMART (OWNER/PRESIDENT) |
| Mailing Address: | 597 Main St South Portland |
| State: | ME US |
| Postal Code: | 041065412 |
| Phone Number: | 2077747242 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2008 |
| NPI Last Update Date: | 09/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | CR594 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |