Provider Demographics
NPI:1427278621
Name:HIGHSMITH, JOHN MARSHALL (DDS DICOI AAACD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MARSHALL
Last Name:HIGHSMITH
Suffix:
Gender:M
Credentials:DDS DICOI AAACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-0869
Mailing Address - Country:US
Mailing Address - Phone:828-627-9282
Mailing Address - Fax:828-627-1702
Practice Address - Street 1:78 NELSON STREET
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-0869
Practice Address - Country:US
Practice Address - Phone:828-627-9282
Practice Address - Fax:828-627-1702
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice