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Individual

ABBIGAYLE NICHOLE DUNLAVY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5201 BOSQUE BLVD STE 200, WACO, TX 76710-4676
(254) 261-6363
Mailing address
2100 S NEW RD APT 928, WACO, TX 76711-1823

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
39572
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/29/2023
Last updated
06/15/2023
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