Individual
DONOVAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2149 W WILLOW ST, SCOTT, LA 70583-5301
(337) 593-0300
Mailing address
2149 W WILLOW ST, SCOTT, LA 70583-5301
(337) 593-0300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4814
LA
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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