Individual
DR. JUSTIN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2407 SAINT ANDREWS BLVD STE A, PANAMA CITY, FL 32405-2170
(850) 763-5021
Mailing address
2407 SAINT ANDREWS BLVD, PANAMA CITY, FL 32405-2170
(850) 763-5021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D0005975-C1
AL
122300000X
Dentist
Primary
DN19194
FL
1223G0001X
General Practice Dentistry
DN 19194
FL
1223G0001X
General Practice Dentistry
DN19194
FL
Other
Enumeration date
08/25/2010
Last updated
09/29/2022
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