Provider Demographics
NPI:1578071221
Name:KNOWLES, SMITH AND ASSOCIATES, LLP
Entity Type:Organization
Organization Name:KNOWLES, SMITH AND ASSOCIATES, LLP
Other - Org Name:VILLAGE KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-485-7070
Mailing Address - Street 1:2028 LITHO PL STE 300
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2538
Mailing Address - Country:US
Mailing Address - Phone:910-485-7070
Mailing Address - Fax:
Practice Address - Street 1:510 HICKORY RIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9779
Practice Address - Country:US
Practice Address - Phone:336-355-0557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty