Organization
DRS. MARK & STEVEN SMITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C SMITH D.D.S (PEDIATRIC DENTIST)
(423) 639-4000
Entity
Organization
Contact information
Practice address
217 N MAIN ST, GREENEVILLE, TN 37745-3815
(423) 639-4000
Mailing address
217 N MAIN ST, GREENEVILLE, TN 37745-3815
(423) 639-4000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS4016
TN
1223P0221X
Pediatric Dentistry
Primary
DS4229
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225103088
GENERAL DENTISTRY
TN
01
—
1881770006
PEDIATRIC DENTISTRY
TN
Enumeration date
03/31/2008
Last updated
03/31/2008
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