Provider Demographics
NPI:1336296607
Name:NESMITH, VERNON R (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:R
Last Name:NESMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 9TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4060
Mailing Address - Country:US
Mailing Address - Phone:940-322-4401
Mailing Address - Fax:
Practice Address - Street 1:2405 9TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4060
Practice Address - Country:US
Practice Address - Phone:940-322-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice