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NPI Code Detail

MEDICARE: DR. WILLIAM CARLOS SMITH JR. D.M.D.

MEDICARE:  DR. WILLIAM CARLOS SMITH JR. 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
11223G0001XGeneral Practice Dentistry1770SC

General Provider Information

NPI Number : 1932269271
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM CARLOS SMITH JR. D.M.D.
Provider Business Mailing Address
First Line : 128 E CIRCLE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-9795
Country : US
Telephone Number : 803-359-2488
Fax Number :
Provider Business Practice Location Address
First Line : 3244 SUNSET BLVD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-3428
Country : US
Telephone Number : 803-794-0146
Fax Number : 803-796-1974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2006
Last Update Date : 07/08/2007

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Directions to “ DR. WILLIAM CARLOS SMITH JR. D.M.D.” Practice Location

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