Provider Demographics
NPI:1346518990
Name:SMITH, JENNIFER CLOUD (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CLOUD
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 1:19012 GULF FWY STE A
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2798
Mailing Address - Country:US
Mailing Address - Phone:281-407-9301
Mailing Address - Fax:
Practice Address - Street 1:19012 GULF FWY STE A
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2798
Practice Address - Country:US
Practice Address - Phone:281-407-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-11
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX275721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice