Individual
MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15492 MAX LEGGETT PARKWAY, SUITE 2, JACKSONVILLE, FL 32218
(904) 414-4500
Mailing address
15492 MAX LEGGETT PARKWAY, SUITE 2, JACKSONVILLE, FL 32218
(904) 414-4500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEN.00202550
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN24056
FL
Other
Enumeration date
06/29/2015
Last updated
12/05/2022
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