# WESTBROOK DENTAL CENTER, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DR. JOHNNY LEE SMITH, D.M.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982248084
- **Authorized official:** DR. JOHNNY L SMITH DMD (DIRECTOR/PRESIDENT/OWNER)
- **Authorized official phone:** (623) 972-6137

## Contact information

- **Practice address:** 9276 W UNION HILLS DR STE A, PEORIA, AZ 85382-8206
- **Practice address phone:** (623) 972-6137
- **Practice address fax:** (623) 972-6334
- **Mailing address:** 9276 W UNION HILLS DR STE A, PEORIA, AZ 85382-8206
- **Mailing address phone:** (623) 972-6137
- **Mailing address fax:** (623) 972-6334

## Taxonomy

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

## Other

- **Enumeration date:** 10/31/2019
- **Last updated:** 01/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1629075130 | INDIVIDUAL NPI | AZ |
| 01 | — | 4489 | LICENSE | AZ |