Provider Demographics
NPI:1134314941
Name:SMITH, ROBERT LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 KNOX VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7102
Mailing Address - Country:US
Mailing Address - Phone:513-476-2186
Mailing Address - Fax:
Practice Address - Street 1:1347 ROCK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6108
Practice Address - Country:US
Practice Address - Phone:615-355-5822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011058A1223G0001X
OH30-0226311223G0001X
TN98301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice