Healthcare Provider Details

I. General information

NPI: 1801830948
Provider Name (Legal Business Name): STEPHEN CRAIG SMART DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 THOMPSON AVE
EL DORADO AR
71730-4569
US

IV. Provider business mailing address

318 THOMPSON AVE
EL DORADO AR
71730-4569
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-0088
  • Fax: 870-862-4230
Mailing address:
  • Phone: 870-863-0088
  • Fax: 870-862-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2321
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: