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General NPI Number Information
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NPI Number | 1922104413
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Entity Type | Individual
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Provider Name | ERIC SMITH D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 18935 GRAND RIVER
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City | DETROIT
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State | MI
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Zip | 48223-0000
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Country | US
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Telephone | 313-835-8280
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Fax | 313-835-2879
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Provider Business Mailing Address
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Address Line | 18935 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48223-2273
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Country | US
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Telephone | 313-835-8280
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Fax | 313-835-2879
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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 | 13513
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24302
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License Number State | TX
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