# LOGAN C SMITH DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smith Dental Team
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649803388
- **Authorized official:** DR. LOGAN CONRAD SMITH DDS (OWNER DENTIST)
- **Authorized official phone:** (616) 855-0005

## Contact information

- **Practice address:** 7706 GEORGETOWN CENTER DR STE A, JENISON, MI 49428-7145
- **Practice address phone:** (616) 855-0005
- **Practice address fax:** (616) 855-0048
- **Mailing address:** 7706 GEORGETOWN CENTER DR STE A, JENISON, MI 49428-7145
- **Mailing address phone:** (616) 855-0005
- **Mailing address fax:** (616) 855-0048

## Taxonomy

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

## Other

- **Enumeration date:** 02/21/2020
- **Last updated:** 02/21/2020