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NPI Code Detail

MEDICARE: DR. EMMETT WARD SMITH D.M.D.

MEDICARE: DR. EMMETT WARD SMITH D.M.D.
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
1122300000XDentist2878AL

General Provider Information

NPI Number : 1376521112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMMETT WARD SMITH D.M.D.
Provider Business Mailing Address
First Line : 3150 ZELDA CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2607
Country : US
Telephone Number : 334-281-2451
Fax Number : 334-281-1087
Provider Business Practice Location Address
First Line : 3150 ZELDA CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2607
Country : US
Telephone Number : 334-281-2451
Fax Number : 334-281-1087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 11/28/2012

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