Provider Demographics
NPI:1144386251
Name:DRS. SMITH & ROBINSON, PA
Entity Type:Organization
Organization Name:DRS. SMITH & ROBINSON, PA
Other - Org Name:DR. PHILIP E. SMITH, DMD, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-359-9991
Mailing Address - Street 1:509 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3605
Mailing Address - Country:US
Mailing Address - Phone:803-359-9991
Mailing Address - Fax:803-359-3004
Practice Address - Street 1:509 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3605
Practice Address - Country:US
Practice Address - Phone:803-359-9991
Practice Address - Fax:803-359-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 18301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9529Medicaid
SCZX3615Medicaid
SCZ18302Medicaid