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Individual

CARSON SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
540 FIELDCREST DR, LADY LAKE, FL 32162-4601
(352) 205-7667
(352) 205-8754
Mailing address
13773 NE 136TH LOOP UNIT 6109, LADY LAKE, FL 32159-6936
(321) 262-2665

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26933
FL

Other

Enumeration date
06/12/2022
Last updated
06/12/2022
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