Provider Demographics
NPI:1043864085
Name:ROBERT T SMITH DDS
Entity Type:Organization
Organization Name:ROBERT T SMITH DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-397-4141
Mailing Address - Street 1:116 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:WA
Mailing Address - Zip Code:99111-1833
Mailing Address - Country:US
Mailing Address - Phone:509-397-4141
Mailing Address - Fax:509-397-9138
Practice Address - Street 1:116 E SPRING ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WA
Practice Address - Zip Code:99111-1833
Practice Address - Country:US
Practice Address - Phone:509-397-4141
Practice Address - Fax:509-397-9138
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT T SMITH DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies