# DOUGLAS J. SMITH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962664458
- **Authorized official:** DOUGLAS J SMITH DDS (OWNER-DENTIST)
- **Authorized official phone:** (208) 356-9262

## Contact information

- **Practice address:** 56 PROFESSIONAL PLZ, REXBURG, ID 83440-2047
- **Practice address phone:** (208) 356-9262
- **Practice address fax:** (208) 356-4804
- **Mailing address:** 56 PROFESSIONAL PLZ, REXBURG, ID 83440-2047
- **Mailing address phone:** (208) 356-9262
- **Mailing address fax:** (208) 356-4804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1433 | ID | Yes |

## Other

- **Enumeration date:** 06/26/2008
- **Last updated:** 06/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001193200 | — | ID |