Individual
KIMBERLY D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
755 US HIGHWAY 21 S, RIDGEWAY, SC 29130-6844
(803) 337-2920
(803) 337-3010
Mailing address
755 US HIGHWAY 21 S, RIDGEWAY, SC 29130-6844
(803) 337-2920
(803) 337-3010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4291
SC
1223G0001X
General Practice Dentistry
DN013063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
599440686A
—
GA
05
—
ZX4291
—
SC
Enumeration date
04/10/2007
Last updated
01/26/2021
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