MEDICARE: DALTON SMITH

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1700718517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALTON SMITH

Provider Business Mailing Address
First Line	:	152 BRAND STE 200
Second Line	:
City	:	MURPHY
State	:	TX
Zip	:	75094-3748
Country	:	US
Telephone Number	:	469-596-6712
Fax Number	:	469-596-6712

Provider Business Practice Location Address
First Line	:	152 BRAND STE 200
Second Line	:
City	:	MURPHY
State	:	TX
Zip	:	75094-3748
Country	:	US
Telephone Number	:	469-596-6712
Fax Number	:	469-596-6712

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ DALTON SMITH ” Practice Location

Language	Start Address	Practice Location

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