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General NPI Number Information
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NPI Number | 1174771125
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Entity Type | Organization
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Legal Business Name | ERIC J SMITH DDS, PC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 4860 RUCKER RD SUITE 3
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City | MONETA
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State | VA
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Zip | 24121-5281
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Country | US
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Telephone | 540-297-7737
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Fax | 540-297-5819
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Provider Business Mailing Address
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Address Line | 4860 RUCKER RD SUITE 3
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City | MONETA
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State | VA
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Zip | 24121-5281
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Country | US
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Telephone | 540-297-7737
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. BARBARA L LANDIS
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Credential |
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Telephone | 540-297-7737
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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 | 0401007612
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License Number State | VA
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