Provider Demographics
NPI:1154666535
Name:ROBIN SMITH D.D.S.
Entity Type:Organization
Organization Name:ROBIN SMITH D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:STRICKLAND
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-266-1714
Mailing Address - Street 1:1312 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4353
Mailing Address - Country:US
Mailing Address - Phone:423-266-1714
Mailing Address - Fax:423-265-5863
Practice Address - Street 1:1312 HANOVER ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4353
Practice Address - Country:US
Practice Address - Phone:423-266-1714
Practice Address - Fax:423-265-5863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44821223G0001X
TN95291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty