Provider Demographics
NPI:1982705844
Name:SMITH, PAUL DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DANIEL
Last Name:SMITH
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 1:4565 DRESSLER RD NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2549
Mailing Address - Country:US
Mailing Address - Phone:330-493-9388
Mailing Address - Fax:330-493-9389
Practice Address - Street 1:4565 DRESSLER RD NW
Practice Address - Street 2:SUITE 102
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2549
Practice Address - Country:US
Practice Address - Phone:330-493-9388
Practice Address - Fax:330-493-9389
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-014719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist