Organization
KIMBERLY BLAIR SMITH DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY BLAIR SMITH DMD (PRESIDENT)
(601) 847-1223
Entity
Organization
Contact information
Practice address
409 MAIN ST N, MENDENHALL, MS 39114-3318
(601) 847-1223
(601) 847-9131
Mailing address
409 MAIN ST N, MENDENHALL, MS 39114-3318
(601) 847-1223
(601) 847-9131
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3186-01
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015751
—
MS
Enumeration date
01/05/2007
Last updated
08/22/2020
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