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Organization

MAUMELLE FAMILY DENTAL CARE

Active
Other names
Keith W. Smith, D.D.S.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEITH WAYNE SMITH D.D.S. (GENERAL DENTIST)
(501) 851-7645
Entity
Organization

Contact information

Practice address
301 MILLWOOD CIR, SUITE 107, MAUMELLE, AR 72113-6319
(501) 851-7645
(501) 851-4281
Mailing address
301 MILLWOOD CIR, SUITE 107, MAUMELLE, AR 72113-6319
(501) 851-7645
(501) 851-4281

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2648
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5T895
BLUE CROSS BLUE SHIELD
AR
01
975050
UNITED CONCORDIA
01
995157
COMPBENEFITS
Enumeration date
08/04/2008
Last updated
08/04/2008
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