| Jacqueline B Smith DDS PLLC | |
|
1385 Fordham Dr Ste 106 Virginia Beach VA 23464-5345 | |
| (757) 424-0095 | |
| (757) 424-2226 |
| Full Name | Jacqueline B Smith DDS PLLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1385 Fordham Dr Ste 106, Virginia Beach, Virginia |
| Authorized Official Name and Position | Jacqueline Brown Smith (GENERAL DENTIST) |
| Authorized Official Contact | 7574240095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline B Smith DDS PLLC 1385 Fordham Dr Ste 106 Virginia Beach VA 23464-5345 Ph: (757) 424-0095 | Jacqueline B Smith DDS PLLC 1385 Fordham Dr Ste 106 Virginia Beach VA 23464-5345 Ph: (757) 424-0095 |
| NPI Number | 1285870188 |
|---|---|
| Provider Enumeration Date | 12/23/2008 |
| Last Update Date | 12/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285870188 | NPI | - | NPPES |
| 899018V | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401411605 (Virginia) | Primary |
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