Provider Demographics
NPI:1588841019
Name:SMITH, SEAN ADRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ADRIAN
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 1:9063 SIEGEN LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1951
Mailing Address - Country:US
Mailing Address - Phone:225-768-1951
Mailing Address - Fax:225-768-1952
Practice Address - Street 1:9063 SIEGEN LN
Practice Address - Street 2:SUITE C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1951
Practice Address - Country:US
Practice Address - Phone:225-768-1951
Practice Address - Fax:225-768-1952
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics