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Individual

DR. JACOB OLIVER SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4307 S PLEASANT CROSSING BLVD STE 103, ROGERS, AR 72758-1347
(479) 553-9215
Mailing address
609 SE HENDRIX ST, BENTONVILLE, AR 72712-4166
(573) 380-8867

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2012019405
MO
1223G0001X
General Practice Dentistry
Primary
4412
AR

Other

Enumeration date
04/22/2013
Last updated
10/04/2021
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