Provider Demographics
NPI:1851490429
Name:SMAIL, DOUGLAS B (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:B
Last Name:SMAIL
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 1:500 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2832
Mailing Address - Country:US
Mailing Address - Phone:518-272-3221
Mailing Address - Fax:
Practice Address - Street 1:500 FEDERAL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2832
Practice Address - Country:US
Practice Address - Phone:518-272-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY446791223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery