Provider Demographics
NPI:1861978579
Name:SMITH, DENNIS LEE JR (RPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:LEE
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 SMITHLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEW BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:16242-2656
Mailing Address - Country:US
Mailing Address - Phone:814-275-3185
Mailing Address - Fax:
Practice Address - Street 1:4075 THIRD ST
Practice Address - Street 2:
Practice Address - City:NUMINE
Practice Address - State:PA
Practice Address - Zip Code:16244
Practice Address - Country:US
Practice Address - Phone:724-783-7341
Practice Address - Fax:724-783-7510
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039213L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist