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General NPI Number Information
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NPI Number | 1821207374
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Entity Type | Individual
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Provider Name | DOUGLAS EDWARD SMITH DDS
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 5102 PAULSEN ST BLDG 8
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City | SAVANNAH
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State | GA
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Zip | 31405-4624
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Country | US
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Telephone | 912-655-8855
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Fax | 912-335-3416
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Provider Business Mailing Address
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Address Line | 5102 PAULSEN ST BLDG 8
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City | SAVANNAH
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State | GA
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Zip | 31405-4624
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Country | US
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Telephone | 912-655-8855
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Fax | 912-335-3416
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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 | GADN008086
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License Number State | GA
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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 | 8086
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License Number State | GA
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