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Individual

DR. WOODY LYLE SMITHEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
900 S VIENNA ST, RUSTON, LA 71270-5830
(318) 251-0334
(318) 255-3538
Mailing address
900 S VIENNA ST, RUSTON, LA 71270-5830
(318) 251-0334
(318) 255-3538

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA 4115
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1841153
LA
01
842233
UNITED CONCORDIA
LA
Enumeration date
10/05/2006
Last updated
07/08/2007
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