Provider Demographics
NPI:1083833057
Name:SMITH, JOSEPH CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
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 1:1640 AKRON PENINSULA RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7908
Mailing Address - Country:US
Mailing Address - Phone:330-928-8288
Mailing Address - Fax:330-928-8688
Practice Address - Street 1:1640 AKRON PENINSULA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7908
Practice Address - Country:US
Practice Address - Phone:330-928-8288
Practice Address - Fax:330-928-8688
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300143511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice