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Provider Information for 1285650531



DR. PETER THOMAS SMRECEK JR. DDS

Gender: MALE

Individual NPI: 1285650531

Calendar Last Updated: 2010-03-23

Details

Name Value
NPI 1285650531
Enumeration Date 2006-07-13
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1401 AVOCADO AVE SUITE 806
NEWPORT BEACH, CA 92660-7720
United States

Phone: 949-759-8606 | Fax: 949-759-8609
View Map External Link
Primary Practice Address 1401 AVOCADO AVE SUITE 806
NEWPORT BEACH, CA 92660-7720
United States

Phone: 949-759-8606 | Fax: 949-759-8609
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 28817