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Provider Information for 1114006491

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

TIMOTHY R SMITH DDS

Gender: MALE

Individual NPI: 1114006491

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1114006491
Enumeration Date 2006-11-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 713 TURTLE CREEK
TYLER, TX 75701
United States

Phone: 903-592-5934 | Fax: 903-597-8822
View Map External Link
Primary Practice Address 713 TURTLE CREEK
TYLER, TX 75701
United States

Phone: 903-592-5934 | Fax: 903-597-8822
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 16601