Organization
JACQUELINE B SMITH DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE BROWN SMITH D.D.S (GENERAL DENTIST)
(757) 424-0095
Entity
Organization
Contact information
Practice address
1385 FORDHAM DR STE 106, VIRGINIA BEACH, VA 23464-5345
(757) 424-0095
(757) 424-2226
Mailing address
1385 FORDHAM DR STE 106, VIRGINIA BEACH, VA 23464-5345
(757) 424-0095
(757) 424-2226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899018V
—
NC
Enumeration date
12/23/2008
Last updated
12/23/2008
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