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Individual
A J SMITH JR.
Active
Individual
A J SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7386
KY
1223G0001X
General Practice Dentistry
Primary
7386
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1341350
UNITED CONCORDIA
KY
01
—
45003167
EPSDT
KY
05
—
60000924
—
KY
Enumeration date
03/19/2007
Last updated
08/15/2008
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