Organization
WESTBROOK DENTAL CENTER, P.A.
Active
Other names
DR. JOHNNY LEE SMITH, D.M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNNY L SMITH DMD (DIRECTOR/PRESIDENT/OWNER)
(623) 972-6137
Entity
Organization
Contact information
Practice address
9276 W UNION HILLS DR STE A, PEORIA, AZ 85382-8206
(623) 972-6137
(623) 972-6334
Mailing address
9276 W UNION HILLS DR STE A, PEORIA, AZ 85382-8206
(623) 972-6137
(623) 972-6334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629075130
INDIVIDUAL NPI
AZ
01
—
4489
LICENSE
AZ
Enumeration date
10/31/2019
Last updated
01/06/2020
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