Organization
NORTHEAST SMILE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENNELL SMITH DDS (DENTIST)
(225) 229-6939
Entity
Organization
Contact information
Practice address
118 N BRICKYARD RD, COLUMBIA, SC 29223-6902
(803) 699-7933
Mailing address
118 N BRICKYARD RD, COLUMBIA, SC 29223-6902
(803) 699-7933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC6936
SC
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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