Individual
GLENDON W SMALLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
117 S CALHOUN ST, DUBLIN, GA 31021
(478) 353-3053
(478) 353-5311
Mailing address
117 S CALHOUN ST, DUBLIN, GA 31021-5245
(478) 353-3053
(478) 353-5311
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN014148
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN014148
GA
Other
Enumeration date
04/21/2010
Last updated
10/18/2019
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