Individual
DR. DOUGLAS EDWARD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5102 PAULSEN ST BLDG 8, SAVANNAH, GA 31405-4624
(912) 655-8855
(912) 335-3416
Mailing address
5102 PAULSEN ST BLDG 8, SAVANNAH, GA 31405-4624
(912) 655-8855
(912) 335-3416
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
8086
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
GADN008086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
274736629
TRICARE PROVIDER & DME SUPPLIER
GA
Enumeration date
05/22/2007
Last updated
07/23/2024
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