Provider Demographics
NPI:1467588467
Name:SMITH & STAHR, PSC
Entity Type:Organization
Organization Name:SMITH & STAHR, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-278-9391
Mailing Address - Street 1:1710 ALEXANDRIA DR
Mailing Address - Street 2:SUITE #3
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3151
Mailing Address - Country:US
Mailing Address - Phone:859-278-9391
Mailing Address - Fax:859-276-2226
Practice Address - Street 1:1710 ALEXANDRIA DR
Practice Address - Street 2:SUITE #3
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3151
Practice Address - Country:US
Practice Address - Phone:859-278-9391
Practice Address - Fax:859-276-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4469 & 46411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty