Provider Demographics
NPI:1477107217
Name:SMITH, JULIAN BRANDT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:BRANDT
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 1:2642 BELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7559
Mailing Address - Country:US
Mailing Address - Phone:334-395-6695
Mailing Address - Fax:
Practice Address - Street 1:2642 BELL ROAD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7559
Practice Address - Country:US
Practice Address - Phone:334-395-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL66991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice