Provider Demographics
NPI:1891141792
Name:SMALTZ, HUGH (DMD)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:
Last Name:SMALTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 HIGHWAY 34 E STE A1
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2191
Mailing Address - Country:US
Mailing Address - Phone:770-254-8000
Mailing Address - Fax:
Practice Address - Street 1:1605 HIGHWAY 34 E STE A1
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2191
Practice Address - Country:US
Practice Address - Phone:770-254-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN010933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist