Individual
MATTHEW OLIVER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
908 MADISON AVE N, DOUGLAS, GA 31533-3126
(912) 384-4902
Mailing address
908 MADISON AVE N, DOUGLAS, GA 31533-3126
(912) 384-4902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014592
GA
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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