Provider Demographics
NPI:1891822185
Name:SMITH & SMITH DDS, PLLC
Entity Type:Organization
Organization Name:SMITH & SMITH DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-343-9131
Mailing Address - Street 1:1501 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25312-2305
Mailing Address - Country:US
Mailing Address - Phone:304-343-9131
Mailing Address - Fax:304-343-2416
Practice Address - Street 1:1501 7TH AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25312-2305
Practice Address - Country:US
Practice Address - Phone:304-343-9131
Practice Address - Fax:304-343-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty