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General NPI Number Information
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NPI Number | 1457342487
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Entity Type | Individual
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Provider Name | ROBERT HENRY SMITH D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 503 N SPALDING AVE
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City | LEBANON
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State | KY
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Zip | 40033-1022
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Country | US
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Telephone | 270-692-3265
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Fax | 270-692-6368
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | LEBANON
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State | KY
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Zip | 40033-0535
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Country | US
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Telephone | 270-692-3265
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Fax | 270-692-6368
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 5594
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License Number State | KY
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