Provider Demographics
NPI:1750669552
Name:SMITH, NATALIE K (DMD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 HEDGCOXE RD
Mailing Address - Street 2:APT 1415
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3885
Mailing Address - Country:US
Mailing Address - Phone:386-299-8807
Mailing Address - Fax:
Practice Address - Street 1:2300 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3322
Practice Address - Country:US
Practice Address - Phone:972-317-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX287581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program