Organization
THOMAS D SMITH DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS DOUGLAS SMITH DMD (OWNER)
(704) 541-5437
Entity
Organization
Contact information
Practice address
10502 PARK RD, SUITE 170, CHARLOTTE, NC 28210-8479
(704) 541-5437
(704) 541-6551
Mailing address
10502 PARK ROAD, SUITE 170, CHARLOTTE, NC 28210-8479
(704) 541-5437
(704) 541-6551
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3967
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GROUP #19
SOLE PROPRIETOR
NC
Enumeration date
03/24/2008
Last updated
03/24/2008
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