Provider Demographics
NPI:1033423421
Name:DARRYL R. SMITH D.D.S.
Entity Type:Organization
Organization Name:DARRYL R. SMITH D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-592-1620
Mailing Address - Street 1:26 PURITAN RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2726
Mailing Address - Country:US
Mailing Address - Phone:781-592-1620
Mailing Address - Fax:781-592-1625
Practice Address - Street 1:26 PURITAN RD
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2726
Practice Address - Country:US
Practice Address - Phone:781-592-1620
Practice Address - Fax:781-592-1625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty