| Dr. Johnny Lee Smith, D.m.d. | |
|
9276 W Union Hills Dr Ste A Peoria AZ 85382-8206 | |
| (623) 972-6137 | |
| (623) 972-6334 |
| Full Name | Dr. Johnny Lee Smith, D.m.d. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9276 W Union Hills Dr Ste A, Peoria, Arizona |
| Authorized Official Name and Position | Johnny L Smith (DIRECTOR/PRESIDENT/OWNER) |
| Authorized Official Contact | 6239726137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Johnny Lee Smith, D.m.d. 9276 W Union Hills Dr Ste A Peoria AZ 85382-8206 Ph: (623) 972-6137 | Dr. Johnny Lee Smith, D.m.d. 9276 W Union Hills Dr Ste A Peoria AZ 85382-8206 Ph: (623) 972-6137 |
| NPI Number | 1982248084 |
|---|---|
| Provider Enumeration Date | 10/31/2019 |
| Last Update Date | 01/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982248084 | NPI | - | NPPES |
| 1629075130 | Other | AZ | INDIVIDUAL NPI |
| 4489 | Other | AZ | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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