Individual
DR. RICHARD L. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
445 FAIRFIELD DR, MADISON, MS 39110-8597
(601) 497-3218
Mailing address
445 FAIRFIELD DR, MADISON, MS 39110-8597
(601) 497-3218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2749-93
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04629211
—
MS
Enumeration date
08/14/2006
Last updated
07/08/2007
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