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Individual
JOHN LEE SMITH
Active
Individual
JOHN LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417676
VA
1223P0300X
Periodontics
Primary
0401417676
VA
1223P0300X
Periodontics
DEN2000471
DC
Other
Enumeration date
09/24/2021
Last updated
07/18/2026
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