MEDICARE: DR. ROBERT LYNN SMITH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12011058A	IN
2	1223G0001X	General Practice Dentistry	30-022631	OH
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	9830	TN

General Provider Information

NPI Number	:	1134314941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LYNN SMITH DMD

Provider Business Mailing Address
First Line	:	1300 KNOX VALLEY DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7102
Country	:	US
Telephone Number	:	513-476-2186
Fax Number	:

Provider Business Practice Location Address
First Line	:	1347 ROCK SPRINGS RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-6108
Country	:	US
Telephone Number	:	615-355-5822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	03/15/2016

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