Organization
JACOB ROGER SMITH DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB ROGER SMITH DDS (OWNER)
(985) 748-4652
Entity
Organization
Contact information
Practice address
416 N 2ND ST, AMITE, LA 70422
(985) 748-4652
(985) 748-7957
Mailing address
416 N 2ND ST, AMITE, LA 70422-2420
(985) 748-4652
(985) 748-7957
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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