Individual
JACOB GANT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 398-6611
Mailing address
502 SE 31ST TER, OCALA, FL 34471-2817
(352) 789-3696
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27214
FL
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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