Individual
DR. KATHRYN DERIVAUX SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2154 GOODMAN RD W, HORN LAKE, MS 38637-1303
(662) 393-9200
Mailing address
1275 FLEETS HARBOR DR, MEMPHIS, TN 38103-8991
(601) 573-2007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3814-15
MS
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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