| Dennis R. Smith Dds, Inc. | |
|
106 College Street 106 College Street Gordon GA 31031-0326 | |
| (478) 628-2142 | |
| (478) 628-1400 |
| Full Name | Dennis R. Smith Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 106 College Street, Gordon, Georgia |
| Authorized Official Name and Position | Dennis R. Smith (OWNER) |
| Authorized Official Contact | 4786282142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis R. Smith Dds, Inc. 106 College Street Gordon GA 31031-0326 Ph: (478) 628-2142 | Dennis R. Smith Dds, Inc. 106 College Street 106 College Street Gordon GA 31031-0326 Ph: (478) 628-2142 |
| NPI Number | 1720133960 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720133960 | NPI | - | NPPES |
| 100138 | Other | GA | AVESIS PEACHSTATE # |
| 108516 | Other | GA | DORAL WELLCARE LOCATOR ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10175 (Georgia) | Primary |