Individual
DR. BALLARD CASSADY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
709 W MAIN ST, MOREHEAD, KY 40351-1443
(606) 784-8983
(606) 784-4408
Mailing address
709 W MAIN ST, MOREHEAD, KY 40351-1443
(606) 784-8983
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8443
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
8443
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000579124
ANTHEM BCBS
—
05
—
7100010590
—
KY
05
—
7100013150
—
KY
Enumeration date
04/12/2007
Last updated
03/26/2024
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