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General NPI Number Information
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NPI Number | 1811239593
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Entity Type | Individual
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Provider Name | THARON L SMITH D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 496 N 990 W, SUITE G
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-477-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 496 N 990 W
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-477-7325
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Fax |
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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 | D008662
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D008662
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9637455-9921
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 101180
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License Number State | CA
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