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NPI 1710085246

NPI 1710085246 : RICHARD DUFF SMITH DDS : CHARLESTON, WV

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General NPI Number Information
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    NPI Number           |    1710085246
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD DUFF SMITH DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1501 SEVENTH AVENUE 
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    City                 |    CHARLESTON
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    State                |    WV
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    Zip                  |    25312
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    Country              |    US
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    Telephone            |    304-343-9131
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    Fax                  |    304-343-2416
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Provider Business Mailing Address
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    Address Line         |    PO BOX 6430 1501 SEVENTH AVENUE
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    City                 |    CHARLESTON
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    State                |    WV
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    Zip                  |    25312
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    Country              |    US
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    Telephone            |    304-343-9131
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    Fax                  |    304-343-2416
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    2243
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    License Number State |    WV
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