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General NPI Number Information
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NPI Number | 1144231978
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Entity Type | Organization
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Legal Business Name | MICHAEL L SMITH DDS INC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 1271 ROBERT C BYRD DR
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City | CRAB ORCHARD
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State | WV
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Zip | 25827-1446
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Country | US
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Telephone | 304-253-4473
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Fax | 304-253-1939
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Provider Business Mailing Address
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Address Line | PO BOX 1446 1271 ROBERT C BYRD DR
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City | CRAB ORCHARD
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State | WV
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Zip | 25827-1446
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Country | US
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Telephone | 304-253-4473
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Fax | 304-253-1939
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Authorized Official
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Title or Position | PRESIDENT DENTIST
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Name | DR. MICHAEL LAWSON SMITH
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Credential | DDS
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Telephone | 304-253-4473
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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 | 3092
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License Number State | WV
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