Individual
DR. RICHARD NELSON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
989 ELLIS AVE, JACKSON, MS 39209-6256
(601) 354-3557
Mailing address
119 LAKEPOINTE DR, MADISON, MS 39110-9203
(541) 729-4969
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4329-23
MS
1223G0001X
General Practice Dentistry
OR5478
OR
Other
Enumeration date
08/09/2006
Last updated
04/28/2023
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