Healthcare Provider Details

I. General information

NPI: 1801027669
Provider Name (Legal Business Name): SMITH & ROY DENTISTRY PARTNERSHIP-DR. KENT SMITH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MACARTHUR BLVD SUITE 100
IRVING TX
75038-6497
US

IV. Provider business mailing address

4301 N MACARTHUR BLVD SUITE 100
IRVING TX
75038-6497
US

V. Phone/Fax

Practice location:
  • Phone: 972-255-3712
  • Fax: 972-255-5693
Mailing address:
  • Phone: 972-255-3712
  • Fax: 972-255-5693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14695
License Number StateTX

VIII. Authorized Official

Name: DR. B. KENT SMITH
Title or Position: D.D.S.
Credential: D.D.S.
Phone: 972-255-3712