Individual
A J SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
201 N ALLISON AVE, BARBOURVILLE, KY 40906-1336
(606) 545-7715
(606) 546-2337
Mailing address
201 N ALLISON AVE, BARBOURVILLE, KY 40906-1336
(606) 545-7715
(606) 546-2337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7386
KY
1223G0001X
General Practice Dentistry
Primary
7386
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1341350
UNITED CONCORDIA
KY
01
—
45003167
EPSDT
KY
05
—
60000924
—
KY
Enumeration date
03/19/2007
Last updated
08/15/2008
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