| Donavan Smith, Dds A Professional Dental Corporation | |
|
2149 W Willow St Scott LA 70583-5301 | |
| (337) 593-0300 | |
| Not Available |
| Full Name | Donavan Smith, Dds A Professional Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 2149 W Willow St, Scott, Louisiana |
| Authorized Official Name and Position | Donavan Jerome Smith (OWNER) |
| Authorized Official Contact | 3375930300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donavan Smith, Dds A Professional Dental Corporation 2149 W Willow St Scott LA 70583-5301 Ph: (337) 593-0300 | Donavan Smith, Dds A Professional Dental Corporation 2149 W Willow St Scott LA 70583-5301 Ph: (337) 593-0300 |
| NPI Number | 1194869446 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194869446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4814 (Louisiana) | Primary |