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General NPI Number Information
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NPI Number | 1508023821
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Entity Type | Organization
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Legal Business Name | BALLARD C SMITH PLLC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 709 W MAIN ST
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City | MOREHEAD
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State | KY
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Zip | 40351-1443
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Country | US
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Telephone | 606-784-8983
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Fax | 606-784-4408
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Provider Business Mailing Address
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Address Line | 709 W MAIN ST
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City | MOREHEAD
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State | KY
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Zip | 40351-1443
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Country | US
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Telephone | 606-784-8983
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Fax | 606-784-4408
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Authorized Official
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Title or Position | OWNER
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Name | BALLARD C SMITH
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Credential | DMD
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Telephone | 606-784-8983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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