Smith, Randy Brooks
Smith, Randy Brooks is an individual health care provider with primary practice located at Rt 1 Box 56 Suite 1, Ripley WV 25271. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, Randy Brooks can be contacted via phone (304) 372-8577.Contact Information
Primary practice address
Rt 1 Box 56 Suite 1
Ripley WV 25271
Phone: (304) 372-8577
Fax: (304) 372-9669
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 1922 | West Virginia |
Profile Details
| NPI number | 1083736714 |
|---|---|
| LBN Legal business name | Smith, Randy Brooks |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083736714 | NPPES |
| West Virginia | MEDICAID | 0136004000 |
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