Provider Demographics
NPI:1083658678
Name:SMITH, STEPHEN C (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 LAFAYETTE RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-1232
Mailing Address - Country:US
Mailing Address - Phone:603-926-4575
Mailing Address - Fax:603-926-7257
Practice Address - Street 1:861 LAFAYETTE RD
Practice Address - Street 2:SUITE #1
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1232
Practice Address - Country:US
Practice Address - Phone:603-926-4575
Practice Address - Fax:603-926-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice