Organization
DENNIS R. SMITH DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS R. SMITH DDS (OWNER)
(478) 628-2142
Entity
Organization
Contact information
Practice address
106 COLLEGE STREET, 106 COLLEGE STREET, GORDON, GA 31031-0326
(478) 628-2142
(478) 628-1400
Mailing address
106 COLLEGE STREET, GORDON, GA 31031-0326
(478) 628-2142
(478) 628-1400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10175
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100138
AVESIS PEACHSTATE #
GA
01
—
108516
DORAL WELLCARE LOCATOR ID
GA
Enumeration date
01/25/2007
Last updated
08/22/2020
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