Provider Demographics
NPI:1245594381
Name:SMITH, BYRON TINDELL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:TINDELL
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 1:100 ANDREW STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-1971
Mailing Address - Country:US
Mailing Address - Phone:256-878-7830
Mailing Address - Fax:
Practice Address - Street 1:100 ANDREW ST
Practice Address - Street 2:SUITE F
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-1971
Practice Address - Country:US
Practice Address - Phone:256-878-7830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics