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 NPI 1124173356
Title
Owner
Phone
(478) 628-2142

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

106 College St
Gordon, GA 31031
Phone (478) 628-2142

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
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

IdentifierTypeStateIssuer
100138OtherGAAVESIS PEACHSTATE #
108516OtherGADORAL WELLCARE LOCATOR ID

Other providers in Gordon, GA

All providers in Gordon, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.