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General NPI Number Information
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NPI Number | 1275500167
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Entity Type | Organization
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Legal Business Name | A. TODD SMITH, DDS PA
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 1601 SOUTH HAWTHORNE ROAD
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City | WINSTON SALEM
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State | NC
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Zip | 27103-4127
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Country | US
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Telephone | 336-765-9550
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Fax | 336-765-9552
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Provider Business Mailing Address
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Address Line | 1601 SOUTH HAWTHORNE ROAD
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City | WINSTON SALEM
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State | NC
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Zip | 27103-4127
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Country | US
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Telephone | 336-765-9550
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Fax | 336-765-9552
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | A TODD SMITH
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Credential | DDS
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Telephone | 336-765-9550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 5848
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 4949
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 3596
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License Number State | NC
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