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General NPI Number Information
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NPI Number | 1659683324
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Entity Type | Individual
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Provider Name | KYLE ALAN SMITH DMD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 2941 PIEDMONT ROAD N.E. SUITE E
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-252-2175
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Fax | 678-735-3148
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Provider Business Mailing Address
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Address Line | 2941 PIEDMONT ROAD N.E. SUITE E
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-237-0556
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Fax | 404-237-0561
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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 | DN014133
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6908
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN014133
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License Number State | GA
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