| NPI | 1235414558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RAY SMITH Dentist/Owner 270-524-5422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 8090) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |