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NPI 1992711881

NPI 1992711881 : DENNIS EDWARD SMITH II D.D.S. : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1992711881
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    Entity Type          |    Individual 
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    Provider Name        |    DENNIS EDWARD SMITH II D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/31/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5620 S MEMORIAL DR 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74145-9016
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    Country              |    US
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    Telephone            |    918-664-8156
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    Fax                  |    918-664-6344
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Provider Business Mailing Address
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    Address Line         |    5620 S MEMORIAL DR 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74145-9016
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    Country              |    US
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    Telephone            |    918-664-8156
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    Fax                  |    918-664-6344
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    5128
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    License Number State |    OK
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