Individual
MICHAEL ROY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
821 SOUTH HWY 25 W, WILLIAMSBURG, KY 40769
(606) 549-0374
(606) 549-0426
Mailing address
PO BOX 547, WILLIAMSBURG, KY 40769-0547
(606) 549-0374
(606) 549-0426
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5249
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60052495
—
KY
Enumeration date
07/31/2006
Last updated
07/08/2007
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