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General NPI Number Information
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NPI Number | 1477649580
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Entity Type | Individual
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Provider Name | CAROL SMITH DDS
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13925 W MEEKER BLVD
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-4430
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Country | US
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Telephone | 623-556-5006
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Fax | 623-556-5564
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Provider Business Mailing Address
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Address Line | 6377 W IRMA LN
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City | GLENDALE
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State | AZ
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Zip | 85308-6611
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Country | US
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Telephone | 623-572-1381
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Fax |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 4627
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License Number State | AZ
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