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General NPI Number Information
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NPI Number | 1811132194
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Entity Type | Organization
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Legal Business Name | G. BENNETT SMITH, DDS & LYNETTE L. SMITH, DDS, PA
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 933 OLD ROCKFORD ST SUITE #7
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City | MOUNT AIRY
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State | NC
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Zip | 27030-5356
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Country | US
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Telephone | 336-789-5306
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Fax | 336-789-3311
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Provider Business Mailing Address
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Address Line | 933 OLD ROCKFORD ST SUITE #7
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City | MOUNT AIRY
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State | NC
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Zip | 27030-5356
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Country | US
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Telephone | 336-789-5306
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Fax | 336-789-3311
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LYNETTE L. SMITH
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Credential | D.D.S.
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Telephone | 336-789-5306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | N/A
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License Number State | NC
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