Organization
LORI SMITH DDS INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI TRIEBEL SMITH DDS (OWNER PRESIDENT DENTIST)
(918) 825-7645
Entity
Organization
Contact information
Practice address
13 SOUTH COOYYAH, PRYOR, OK 74361
(918) 825-7645
(918) 825-7646
Mailing address
13 SOUTH COOYYAH, PRYOR, OK 74361
(918) 825-7645
(918) 825-7646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5334
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100150130A
—
OK
01
—
455716222001
BLUE CROSS SHIELD OF OK
OK
Enumeration date
09/22/2006
Last updated
04/24/2008
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