Provider Demographics
NPI:1588875736
Name:SMITH, GAYLIA CHAVIS (DDS)
Entity type:Individual
Prefix:DR
First Name:GAYLIA
Middle Name:CHAVIS
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 BURLINGTON AVE
Mailing Address - Street 2:P. O. BOX 198
Mailing Address - City:GIBSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27249-2865
Mailing Address - Country:US
Mailing Address - Phone:336-449-6423
Mailing Address - Fax:336-449-9200
Practice Address - Street 1:408 BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GIBSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27249-2865
Practice Address - Country:US
Practice Address - Phone:336-449-6423
Practice Address - Fax:336-449-9200
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice