Provider Demographics
NPI:1437581360
Name:SMITH, ALEXANDER JOHN SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JOHN SCOTT
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 1:131 S LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-9340
Mailing Address - Country:US
Mailing Address - Phone:154-172-9246
Mailing Address - Fax:
Practice Address - Street 1:265 WESTLAKE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-4869
Practice Address - Country:US
Practice Address - Phone:910-864-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023946122300000X
NC9995122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist