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NPI 1790793867

NPI 1790793867 : STEVEN WAYNE SMITH DDS : CEDAR PARK, TX

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General NPI Number Information
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    NPI Number           |    1790793867
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN WAYNE SMITH DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/04/2006
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    Last Update Date     |    04/13/2011
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Provider Practice Location Address
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    Address Line         |    100 N LAKELINE BLVD 
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    City                 |    CEDAR PARK
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    State                |    TX
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    Zip                  |    78613-6798
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    Country              |    US
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    Telephone            |    512-219-1389
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    Fax                  |    512-219-0725
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Provider Business Mailing Address
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    Address Line         |    100 N LAKELINE BLVD 
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    City                 |    CEDAR PARK
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    State                |    TX
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    Zip                  |    78613-6798
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    Country              |    US
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    Telephone            |    512-219-1389
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    Fax                  |    512-219-0725
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    15539
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    License Number State |    TX
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