Individual
MR. SCOTT WADE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4376 LAWRENCEVILLE RD, LOGANVILLE, GA 30052-2335
(770) 466-0363
(770) 466-0182
Mailing address
4376 LAWRENCEVILLE RD, LOGANVILLE, GA 30052-2335
(770) 466-0363
(770) 466-0182
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10571
GA
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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