Dennis R. Smith DDS, Inc.
Organization Active NPI General Practice Dentistry · Gordon, GA
NPI 1720133960 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1720133960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10175 (GA)
- Legal business name
- DENNIS R. SMITH DDS, INC.
- Practice address
- 106 College Street
106 College Street
Gordon, GA 31031-0326 - Phone
- (478) 628-2142
- Fax
- (478) 628-1400
- NPI assigned
- Jan 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Dennis R. Smith, DDS
- Title
- Owner
- Phone
- (478) 628-2142
Practitioners 1
-
Dennis Rayvon Smith, DDS
National Provider Directory
Locations
106 College St
Gordon, GA 31031
Phone (478) 628-2142
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 10175 | GA | Yes |
Addresses
Primary practice location
106 College Street
106 College Street
Gordon, GA 31031-0326
Mailing address
106 College Street
Gordon, GA 31031-0326
Phone (478) 628-2142
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100138 | Other | GA | AVESIS PEACHSTATE # |
| 108516 | Other | GA | DORAL WELLCARE LOCATOR ID |
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- Falcon Crest Manor, LLC
- Jonathan William Goodan
- Gordon Drugs, Inc.
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All providers in Gordon, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.