Individual
DR. NATHAN RANDALL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3220 5TH AVE S # DEW2002, BIRMINGHAM, AL 35222-2309
(205) 975-9842
Mailing address
3220 5TH AVE S #DEW2002, BIRMINGHAM, AL 35222-2309
(205) 975-9842
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5436
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910280
—
AL
05
—
107861
—
AL
05
—
123847
—
AL
01
—
510-48371
BLUE CROSS BLUE SHIELD WESTERN DENTAL
AL
01
—
515-41700
BLUE CROSS BLUE SHIELD EASTERN DENTAL
AL
Enumeration date
10/18/2006
Last updated
10/16/2024
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