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General NPI Number Information
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NPI Number | 1902981319
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Entity Type | Organization
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Legal Business Name | ROBERT G. SMITH, DDS, CHTD.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 3700 W 83RD ST SUITE 103
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5121
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Country | US
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Telephone | 913-649-5600
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Fax | 913-649-2069
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Provider Business Mailing Address
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Address Line | 3700 W 83RD ST SUITE 103
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-5121
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Country | US
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Telephone | 913-649-5600
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Fax | 913-649-2069
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Authorized Official
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Title or Position | BUS. MNGR
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Name | SHERRY L FADDIS
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Credential |
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Telephone | 913-649-5600
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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 | 4936
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License Number State | KS
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