Provider Demographics
NPI:1821110677
Name:MICHAEL G. SMITH DMD PLLC
Entity Type:Organization
Organization Name:MICHAEL G. SMITH DMD PLLC
Other - Org Name:TEMPE
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-839-0502
Mailing Address - Street 1:6200 S MCCLINTOCK DR
Mailing Address - Street 2:STE #5
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3268
Mailing Address - Country:US
Mailing Address - Phone:480-839-0502
Mailing Address - Fax:
Practice Address - Street 1:6200 S MCCLINTOCK DR
Practice Address - Street 2:STE #5
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3268
Practice Address - Country:US
Practice Address - Phone:480-839-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental