MEDICARE: REAGAN SMITH, DDS, PLLC

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

General Provider Information

NPI Number	:	1942934278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAGAN SMITH, DDS, PLLC

Provider Business Mailing Address
First Line	:	2525 LOUETTA RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-4785
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 LOUETTA RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-4785
Country	:	US
Telephone Number	:	281-350-8852
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	DR. REAGAN SMITH
Credential	:	DDS
Telephone Number	:	512-289-5597

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	03/27/2024

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