Provider Demographics
NPI:1144343856
Name:SMITH, GEORGE ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARTHUR
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 CUSTER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7599
Mailing Address - Country:US
Mailing Address - Phone:972-867-4430
Mailing Address - Fax:972-964-3300
Practice Address - Street 1:3401 CUSTER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7599
Practice Address - Country:US
Practice Address - Phone:972-867-4430
Practice Address - Fax:972-964-3300
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice