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General NPI Number Information
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NPI Number | 1780892596
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Entity Type | Organization
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Legal Business Name | J. KEITH SMITH, D.M.D., P.C.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1777 LEE RD SUITE D
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-3073
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Country | US
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Telephone | 770-948-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 1777 LEE RD SUITE D
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-3073
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Country | US
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Telephone | 770-948-1600
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. JAMES KEITH SMITH
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Credential | D.M.D.
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Telephone | 770-948-1600
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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 | DN011118
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License Number State | GA
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