Healthcare Provider Details

I. General information

NPI: 1548123722
Provider Name (Legal Business Name): SMITH DENTAL SPECIALTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5102 PAULSEN ST
SAVANNAH GA
31405-4601
US

IV. Provider business mailing address

5102 PAULSEN ST
SAVANNAH GA
31405-4601
US

V. Phone/Fax

Practice location:
  • Phone: 912-755-0409
  • Fax: 912-335-3416
Mailing address:
  • Phone: 912-755-0409
  • Fax: 912-335-3416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CYNTHIA ANITA HUCKS-SMITH
Title or Position: OWNER
Credential: PHD
Phone: 912-755-0409