Individual
DR. DUSTIN G. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1718 S MAIN ST, POPLARVILLE, MS 39470-4287
(601) 795-8024
(601) 795-0745
Mailing address
PO BOX 73, 1718 SOUTH MAIN STREET, POPLARVILLE, MS 39470-0073
(601) 795-8024
(601) 795-0745
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3142-00
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660344
—
MS
01
—
781236
UNITED CONCORDIA
MS
Enumeration date
07/17/2006
Last updated
07/08/2007
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