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General NPI Number Information
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NPI Number | 1407058662
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Entity Type | Organization
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Legal Business Name | J.SCOTT SMITH D.D.S.,P.A.
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2915 E MOORE AVE STE.2
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City | SEARCY
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State | AR
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Zip | 72143-4821
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Country | US
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Telephone | 501-268-5815
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Fax | 501-268-5816
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Provider Business Mailing Address
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Address Line | 2915 EAST MOORE ST.,STE.2
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City | SEARCY
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State | AR
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Zip | 72143-2915
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Country | US
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Telephone | 501-268-5815
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Fax | 501-268-5816
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY SCOTT SMITH
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Credential | D.D.S.
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Telephone | 501-268-5815
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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 | 3052
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License Number State | AR
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