Provider Demographics
NPI:1215023288
Name:WKSMITH & JASMITH, PA
Entity type:Organization
Organization Name:WKSMITH & JASMITH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VAFAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-893-8706
Mailing Address - Street 1:136 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2904
Mailing Address - Country:US
Mailing Address - Phone:410-893-8706
Mailing Address - Fax:410-893-3691
Practice Address - Street 1:136 E BROADWAY
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2904
Practice Address - Country:US
Practice Address - Phone:410-893-8706
Practice Address - Fax:410-893-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124841223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty