Provider Demographics
NPI:1942430467
Name:SMITH, STEVEN WILLIAM JR (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WILLIAM
Last Name:SMITH
Suffix:JR
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 1:1112 NC HIGHWAY 210
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9139
Mailing Address - Country:US
Mailing Address - Phone:910-741-1555
Mailing Address - Fax:910-741-4051
Practice Address - Street 1:1112 NC HIGHWAY 210
Practice Address - Street 2:
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460-9139
Practice Address - Country:US
Practice Address - Phone:910-741-1555
Practice Address - Fax:910-741-4051
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice