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Individual

DR. MICHAEL SHANE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1202 CLEO WAY STE 3, DALTON, GA 30720-8356
(804) 828-6498
Mailing address
512 SCOTTER HILLS LN, MIDLOTHIAN, VA 23114-5541
(804) 828-6498

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013493
GA
122300000X
Dentist
DS 7804
TN

Other

Enumeration date
05/27/2007
Last updated
07/08/2007
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