Individual
DR. RANDY BROOKS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
RT 1 BOX 56, SUITE 1, RIPLEY, WV 25271
(304) 372-8577
(304) 372-9669
Mailing address
RT 1 BOX 56, SUITE 1, RIPLEY, WV 25271
(304) 372-8577
(304) 372-9669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1922
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136004000
—
WV
Enumeration date
04/04/2007
Last updated
07/08/2007
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