Individual
DR. DAMONE E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12651 W SUNRISE BLVD, #304, SUNRISE, FL 33323-0906
(954) 845-0098
(954) 845-0280
Mailing address
12651 W SUNRISE BLVD, #304, SUNRISE, FL 33323-0906
(954) 845-0098
(954) 845-0280
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DN16448
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN16448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201435221
TAX ID
FL
05
—
690057701
—
FL
05
—
690057796
—
FL
Enumeration date
03/15/2007
Last updated
12/26/2018
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