Provider Demographics
NPI:1104822378
Name:SMITH, STANLEY JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JAMES
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 1:810 S MASON RD
Mailing Address - Street 2:STE 215
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3857
Mailing Address - Country:US
Mailing Address - Phone:281-395-2112
Mailing Address - Fax:281-395-4706
Practice Address - Street 1:810 S MASON RD
Practice Address - Street 2:STE 215
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3857
Practice Address - Country:US
Practice Address - Phone:281-395-2112
Practice Address - Fax:281-395-4706
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist