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Organization
A. TODD SMITH, DDS PA
Active
Organization
A. TODD SMITH, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A TODD SMITH DDS (ORAL SURGEON)
(336) 765-9550
Entity
Organization
Contact information
Practice address
1601 SOUTH HAWTHORNE ROAD, WINSTON SALEM, NC 27103-4127
(336) 765-9550
(336) 765-9552
Mailing address
1601 SOUTH HAWTHORNE ROAD, WINSTON SALEM, NC 27103-4127
(336) 765-9550
(336) 765-9552
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
3596
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4949
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
5848
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7997761
—
NC
05
—
8997869
—
NC
Enumeration date
03/01/2006
Last updated
03/19/2010
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