Doctor Name: | DR. MITCHELL ALAN SMOLOW |
NPI Number: | 1679795330 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.M.D. |
License Number: | DS020248L |
Business Practice Address: | 720 Hampton Rd Shavertown, PA - 187089527 |
Business Phone Number: | 5707144000 |
Business Fax Number: | 5706963320 |
Mailing Address: | 720 Hampton Rd, SHAVERTOWN |
State: | PA |
Postal Code: | 187089527 |
Phone Number: | 5707144000 |
Fax Number: | 5706963320 |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DS020248L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |