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General NPI Number Information
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NPI Number | 1225628167
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Entity Type | Individual
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Provider Name | PAUL STEPHEN SMITH DDS
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Gender | Male
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | BLDG 140
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City | RAF CROUGHTON
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State | TX
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Zip | 09494
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Country | US
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Telephone | 314-236-8739
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Fax |
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Provider Business Mailing Address
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Address Line | 300 TUSKEGEE BLVD
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City | DOVER AIR FORCE BASE
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State | DE
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Zip | 19902-5003
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Country | US
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Telephone | 302-677-2028
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Fax | 302-677-3231
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35141
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License Number State | TX
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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 | 35141
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License Number State | TX
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