Healthcare Provider Details

I. General information

NPI: 1366545659
Provider Name (Legal Business Name): ROXANNE DONAGHEY SMITH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 FM 902 W.
HOWE TX
75459-0400
US

IV. Provider business mailing address

PO BOX 400 7811 FM 902 W.
HOWE TX
75459-0400
US

V. Phone/Fax

Practice location:
  • Phone: 903-532-3990
  • Fax: 903-532-6161
Mailing address:
  • Phone: 903-532-3990
  • Fax: 903-532-6161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12908
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: