| B Kent Smith Dds Pa | |
|
290 E John Carpenter Fwy #2700 Irving TX 75062-2730 | |
| (972) 255-3712 | |
| (972) 255-5693 |
| Full Name | B Kent Smith Dds Pa |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 290 E John Carpenter Fwy, Irving, Texas |
| Authorized Official Name and Position | Brady Kent Smith (OWNER) |
| Authorized Official Contact | 9722553712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| B Kent Smith Dds Pa 290 E John Carpenter Fwy #2700 Irving TX 75062-2730 Ph: (972) 255-3712 | B Kent Smith Dds Pa 290 E John Carpenter Fwy #2700 Irving TX 75062-2730 Ph: (972) 255-3712 |
| NPI Number | 1417244054 |
|---|---|
| Provider Enumeration Date | 07/04/2011 |
| Last Update Date | 01/18/2022 |
| Medicare PECOS PAC ID | 3375713662 |
|---|---|
| Medicare Enrollment ID | O20110824000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417244054 | NPI | - | NPPES |
| 1417244054 | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14695 (Texas) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Primary |
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