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General NPI Number Information
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NPI Number | 1104073493
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Entity Type | Individual
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Provider Name | KATHY MEREDITH SMITH DMD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 4875 FLOYD RD SW SUITE 113
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City | MABLETON
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State | GA
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Zip | 30126-1379
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Country | US
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Telephone | 770-732-0900
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Fax | 770-732-0988
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Provider Business Mailing Address
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Address Line | 4875 FLOYD RD SW SUITE 113
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City | MABLETON
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State | GA
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Zip | 30126-1379
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Country | US
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Telephone | 770-732-0900
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Fax | 770-732-0988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN009008
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4591
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License Number State | NC
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