Provider Demographics
NPI:1336587674
Name:SMALLWOOD AND MCKOWN-SMALLWOOD, DDS, P.C.
Entity Type:Organization
Organization Name:SMALLWOOD AND MCKOWN-SMALLWOOD, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-997-0353
Mailing Address - Street 1:4102 QUARLES CT
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8797
Mailing Address - Country:US
Mailing Address - Phone:540-433-2288
Mailing Address - Fax:
Practice Address - Street 1:4102 QUARLES CT
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8797
Practice Address - Country:US
Practice Address - Phone:540-433-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014139711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty