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NPI Code Detail

MEDICARE: DR. CHARLES EDWARD SMAHA DMD

MEDICARE: DR. CHARLES EDWARD SMAHA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN012749GA

General Provider Information

NPI Number : 1770741704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES EDWARD SMAHA DMD
Provider Business Mailing Address
First Line : 151 PIERCE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2821
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 151 PIERCE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2821
Country : US
Telephone Number : 478-743-9331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 05/27/2008

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Directions to “ DR. CHARLES EDWARD SMAHA DMD” Practice Location

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