# SMITHS GROVE FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528568789
- **Authorized official:** GARY PHILLIP WALDEN DMD (OWNER)
- **Authorized official phone:** (270) 563-4819

## Contact information

- **Practice address:** 148 VINCENT ST, SMITHS GROVE, KY 42171-8183
- **Practice address phone:** (270) 563-4819
- **Practice address fax:** (270) 563-0088
- **Mailing address:** PO BOX 370, SMITHS GROVE, KY 42171-0370
- **Mailing address phone:** (270) 563-4819
- **Mailing address fax:** (270) 563-0088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9168 | KY | Yes |

## Other

- **Enumeration date:** 02/14/2018
- **Last updated:** 02/14/2018