Marissa W Smith, DMD
Individual provider Active NPI General Practice Dentistry · Wesson, MS
NPI 1740916568 · NPPES record last updated Jul 25, 2022
Key facts
- NPI
- 1740916568
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4302-22 (MS)
- Practice address
- 1024 Spring Street
Wesson, MS 39191 - Phone
- (601) 748-6699
- NPI assigned
- Jul 25, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4302-22 | MS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Family Dental LLC | Current |
Accepting new patients |
Locations
1024 Spring St
Wesson, MS 39191
Phone (601) 714-2278
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4302-22 | MS | Yes |
Addresses
Primary practice location
1024 Spring Street
Wesson, MS 39191
Mailing address
PO Box 873
Wesson, MS 39191-0873
Phone (601) 748-6699
Other providers in Wesson, MS
- Rochland Shunta Porter
- Marcella Roberts
- Rebecca Lind Schrader
- Chastity Quayondra Sims
- Angela N Smith
- The Oliver House Adult Daycare
- Nathaniel Tillman
- Yvette Tillman
All providers in Wesson, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2022. 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.