Healthcare Provider Details

I. General information

NPI: 1578532024
Provider Name (Legal Business Name): R. KUHEN SMITH D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 S WHITE STATION RD SUITE 1
MEMPHIS TN
38117-4579
US

IV. Provider business mailing address

766 S WHITE STATION RD SUITE 1
MEMPHIS TN
38117-4579
US

V. Phone/Fax

Practice location:
  • Phone: 901-685-8090
  • Fax: 901-684-1662
Mailing address:
  • Phone: 901-685-8090
  • Fax: 901-684-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: