Provider Demographics
NPI:1235241050
Name:SMITH, SUSAN SCHMITZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:SCHMITZ
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 MALL RING CIRCLE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-967-1700
Mailing Address - Fax:702-967-1703
Practice Address - Street 1:731 MALL RING CIRCLE
Practice Address - Street 2:SUITE 203
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-967-1700
Practice Address - Fax:702-967-1703
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV83721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice