Healthcare Provider Details

I. General information

NPI: 1669691903
Provider Name (Legal Business Name): ANDREW B SMITH DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/26/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 N FOUNTAIN GREEN RD
BEL AIR MD
21015
US

IV. Provider business mailing address

2110 N FOUNTAIN GREEN RD
BEL AIR MD
21015
US

V. Phone/Fax

Practice location:
  • Phone: 410-628-0920
  • Fax:
Mailing address:
  • Phone: 410-628-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberMD13793
License Number StateMD

VIII. Authorized Official

Name: JENNY GARCIA-ROCHA
Title or Position: SENIOR CREDENTIALING TEAM LEAD
Credential:
Phone: 972-869-3789