Individual
DR. JOHN ALBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
910 MEDALLION DR, GREENWOOD, MS 38930-2118
(662) 455-9149
(662) 453-1495
Mailing address
910 MEDALLION DR, GREENWOOD, MS 38930-2118
(662) 455-9149
(662) 453-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
185279
MS
Other
Enumeration date
09/30/2006
Last updated
07/08/2007
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