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General NPI Number Information
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NPI Number | 1508011099
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Entity Type | Organization
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Legal Business Name | JAMES D. SMITH DDS, L.L.C.
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 104 S. STERLING
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City | SUGAR CREEK
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State | MO
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Zip | 64054
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Country | US
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Telephone | 816-254-6557
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Fax | 816-254-6550
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Provider Business Mailing Address
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Address Line | 104 S. STERLING
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City | SUGAR CREEK
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State | MO
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Zip | 64054
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Country | US
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Telephone | 816-254-6557
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Fax | 816-254-6550
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Authorized Official
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Title or Position | DENTIST
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Name | JAMES D. SMITH
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Credential | D.D.S., L.L.C.
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Telephone | 816-254-6557
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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 | 12771
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License Number State | MO
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