Provider Demographics
NPI:1417079294
Name:SMITH, ALAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:SMITH
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 1:14000 CANTRELL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1510
Mailing Address - Country:US
Mailing Address - Phone:501-225-0300
Mailing Address - Fax:501-225-0301
Practice Address - Street 1:14000 CANTRELL RD
Practice Address - Street 2:SUITE C
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1510
Practice Address - Country:US
Practice Address - Phone:501-225-0300
Practice Address - Fax:501-225-0301
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR28731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice