Individual
GLENNELL S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7212 BROOKFIELD RD, COLUMBIA, SC 29223-2202
(803) 626-1265
(803) 337-3010
Mailing address
7212 BROOKFIELD RD, COLUMBIA, SC 29223-2202
(803) 626-1265
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX6936
—
SC
Enumeration date
10/06/2010
Last updated
04/20/2021
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